Daily Papers

Automating radiology report generation can significantly alleviate radiologists' workloads. Previous research has primarily focused on realizing highly concise observations while neglecting the precise attributes that determine the severity of diseases (e.g., small pleural effusion). Since incorrect attributes will lead to imprecise radiology reports, strengthening the generation process with precise attribute modeling becomes necessary. Additionally, the temporal information contained in the historical records, which is crucial in evaluating a patient's current condition (e.g., heart size is unchanged), has also been largely disregarded. To address these issues, we propose RECAP, which generates precise and accurate radiology reports via dynamic disease progression reasoning. Specifically, RECAP first predicts the observations and progressions (i.e., spatiotemporal information) given two consecutive radiographs. It then combines the historical records, spatiotemporal information, and radiographs for report generation, where a disease progression graph and dynamic progression reasoning mechanism are devised to accurately select the attributes of each observation and progression. Extensive experiments on two publicly available datasets demonstrate the effectiveness of our model.

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

The breakthrough of OpenAI o1 highlights the potential of enhancing reasoning to improve LLM. Yet, most research in reasoning has focused on mathematical tasks, leaving domains like medicine underexplored. The medical domain, though distinct from mathematics, also demands robust reasoning to provide reliable answers, given the high standards of healthcare. However, verifying medical reasoning is challenging, unlike those in mathematics. To address this, we propose verifiable medical problems with a medical verifier to check the correctness of model outputs. This verifiable nature enables advancements in medical reasoning through a two-stage approach: (1) using the verifier to guide the search for a complex reasoning trajectory for fine-tuning LLMs, (2) applying reinforcement learning (RL) with verifier-based rewards to enhance complex reasoning further. Finally, we introduce HuatuoGPT-o1, a medical LLM capable of complex reasoning, which outperforms general and medical-specific baselines using only 40K verifiable problems. Experiments show complex reasoning improves medical problem-solving and benefits more from RL. We hope our approach inspires advancements in reasoning across medical and other specialized domains.

While Large Language Models (LLMs) have demonstrated their proficiency in complex reasoning tasks, their performance in dynamic, interactive, and competitive scenarios - such as business strategy and stock market analysis - remains underexplored. To bridge this gap, we formally explore the dynamic reasoning capabilities of LLMs for decision-making in rapidly evolving environments. We introduce two game theory-based pilot challenges that mirror the complexities of real-world dynamic decision-making. These challenges are well-defined, enabling clear, controllable, and precise evaluation of LLMs' dynamic reasoning abilities. Through extensive experiments, we find that existing reasoning methods tend to falter in dynamic settings that require k-level thinking - a key concept not tackled by previous works. To address this, we propose a novel reasoning approach for LLMs, named "K-Level Reasoning". This approach adopts the perspective of rivals to recursively employ k-level thinking based on available historical information, which significantly improves the prediction accuracy of rivals' subsequent moves and informs more strategic decision-making. This research not only sets a robust quantitative benchmark for the assessment of dynamic reasoning but also markedly enhances the proficiency of LLMs in dynamic contexts.

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

Large language models (LLMs), particularly those with reasoning capabilities, have rapidly advanced in recent years, demonstrating significant potential across a wide range of applications. However, their deployment in healthcare, especially in disease reasoning tasks, is hindered by the challenge of acquiring expert-level cognitive data. In this paper, we introduce Citrus, a medical language model that bridges the gap between clinical expertise and AI reasoning by emulating the cognitive processes of medical experts. The model is trained on a large corpus of simulated expert disease reasoning data, synthesized using a novel approach that accurately captures the decision-making pathways of clinicians. This approach enables Citrus to better simulate the complex reasoning processes involved in diagnosing and treating medical conditions.To further address the lack of publicly available datasets for medical reasoning tasks, we release the last-stage training data, including a custom-built medical diagnostic dialogue dataset. This open-source contribution aims to support further research and development in the field. Evaluations using authoritative benchmarks such as MedQA, covering tasks in medical reasoning and language understanding, show that Citrus achieves superior performance compared to other models of similar size. These results highlight Citrus potential to significantly enhance medical decision support systems, providing a more accurate and efficient tool for clinical decision-making.

Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAIs O1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical language model, \mone, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the reward model. During inference, the policy model generates multiple responses, and the reward model selects the one with the highest reward score. Experiments on eleven evaluation datasets demonstrate that \mone outperforms prior open-source models by 2 points, with the addition of the reward model further boosting performance (sim13 points), surpassing GPT-4o-mini. Code and data are available at https://github.com/pixas/MedSSS.

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

Reasoning is a critical frontier for advancing medical image analysis, where transparency and trustworthiness play a central role in both clinician trust and regulatory approval. Although Medical Visual Language Models (VLMs) show promise for radiological tasks, most existing VLMs merely produce final answers without revealing the underlying reasoning. To address this gap, we introduce MedVLM-R1, a medical VLM that explicitly generates natural language reasoning to enhance transparency and trustworthiness. Instead of relying on supervised fine-tuning (SFT), which often suffers from overfitting to training distributions and fails to foster genuine reasoning, MedVLM-R1 employs a reinforcement learning framework that incentivizes the model to discover human-interpretable reasoning paths without using any reasoning references. Despite limited training data (600 visual question answering samples) and model parameters (2B), MedVLM-R1 boosts accuracy from 55.11% to 78.22% across MRI, CT, and X-ray benchmarks, outperforming larger models trained on over a million samples. It also demonstrates robust domain generalization under out-of-distribution tasks. By unifying medical image analysis with explicit reasoning, MedVLM-R1 marks a pivotal step toward trustworthy and interpretable AI in clinical practice.

Reinforcement learning from verifiable rewards (RLVR) has recently gained attention for its ability to elicit self-evolved reasoning capabilitie from base language models without explicit reasoning supervisions, as demonstrated by DeepSeek-R1. While prior work on RLVR has primarily focused on mathematical and coding domains, its applicability to other tasks and domains remains unexplored. In this work, we investigate whether medical reasoning can emerge from RLVR. We introduce Med-RLVR as an initial study of RLVR in the medical domain leveraging medical multiple-choice question answering (MCQA) data as verifiable labels. Our results demonstrate that RLVR is not only effective for math and coding but also extends successfully to medical question answering. Notably, Med-RLVR achieves performance comparable to traditional supervised fine-tuning (SFT) on in-distribution tasks while significantly improving out-of-distribution generalization, with an 8-point accuracy gain. Further analysis of training dynamics reveals that, with no explicit reasoning supervision, reasoning emerges from the 3B-parameter base model. These findings underscore the potential of RLVR in domains beyond math and coding, opening new avenues for its application in knowledge-intensive fields such as medicine.

Large Language Models (LLMs) increasingly rely on prolonged reasoning chains to solve complex tasks. However, this trial-and-error approach often leads to high computational overhead and error propagation, where early mistakes can derail subsequent steps. To address these issues, we introduce Meta-Reasoner, a framework that dynamically optimizes inference-time reasoning by enabling LLMs to "think about how to think." Drawing inspiration from human meta-cognition and dual-process theory, Meta-Reasoner operates as a strategic advisor, decoupling high-level guidance from step-by-step generation. It employs "contextual multi-armed bandits" to iteratively evaluate reasoning progress, and select optimal strategies (e.g., backtrack, clarify ambiguity, restart from scratch, or propose alternative approaches), and reallocates computational resources toward the most promising paths. Our evaluations on mathematical reasoning and puzzles highlight the potential of dynamic reasoning chains to overcome inherent challenges in the LLM reasoning process and also show promise in broader applications, offering a scalable and adaptable solution for reasoning-intensive tasks.

We provide an optimization-based framework to perform counterfactual analysis in a dynamic model with hidden states. Our framework is grounded in the ``abduction, action, and prediction'' approach to answer counterfactual queries and handles two key challenges where (1) the states are hidden and (2) the model is dynamic. Recognizing the lack of knowledge on the underlying causal mechanism and the possibility of infinitely many such mechanisms, we optimize over this space and compute upper and lower bounds on the counterfactual quantity of interest. Our work brings together ideas from causality, state-space models, simulation, and optimization, and we apply it on a breast cancer case study. To the best of our knowledge, we are the first to compute lower and upper bounds on a counterfactual query in a dynamic latent-state model.

As opposed to evaluating computation and logic-based reasoning, current benchmarks for evaluating large language models (LLMs) in medicine are primarily focused on question-answering involving domain knowledge and descriptive reasoning. While such qualitative capabilities are vital to medical diagnosis, in real-world scenarios, doctors frequently use clinical calculators that follow quantitative equations and rule-based reasoning paradigms for evidence-based decision support. To this end, we propose MedCalc-Bench, a first-of-its-kind dataset focused on evaluating the medical calculation capability of LLMs. MedCalc-Bench contains an evaluation set of over 1000 manually reviewed instances from 55 different medical calculation tasks. Each instance in MedCalc-Bench consists of a patient note, a question requesting to compute a specific medical value, a ground truth answer, and a step-by-step explanation showing how the answer is obtained. While our evaluation results show the potential of LLMs in this area, none of them are effective enough for clinical settings. Common issues include extracting the incorrect entities, not using the correct equation or rules for a calculation task, or incorrectly performing the arithmetic for the computation. We hope our study highlights the quantitative knowledge and reasoning gaps in LLMs within medical settings, encouraging future improvements of LLMs for various clinical calculation tasks.

Deep neural networks are often applied to medical images to automate the problem of medical diagnosis. However, a more clinically relevant question that practitioners usually face is how to predict the future trajectory of a disease. Current methods for prognosis or disease trajectory forecasting often require domain knowledge and are complicated to apply. In this paper, we formulate the prognosis prediction problem as a one-to-many prediction problem. Inspired by a clinical decision-making process with two agents -- a radiologist and a general practitioner -- we predict prognosis with two transformer-based components that share information with each other. The first transformer in this framework aims to analyze the imaging data, and the second one leverages its internal states as inputs, also fusing them with auxiliary clinical data. The temporal nature of the problem is modeled within the transformer states, allowing us to treat the forecasting problem as a multi-task classification, for which we propose a novel loss. We show the effectiveness of our approach in predicting the development of structural knee osteoarthritis changes and forecasting Alzheimer's disease clinical status directly from raw multi-modal data. The proposed method outperforms multiple state-of-the-art baselines with respect to performance and calibration, both of which are needed for real-world applications. An open-source implementation of our method is made publicly available at https://github.com/Oulu-IMEDS/CLIMATv2.

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

In medical applications, deep learning methods are built to automate diagnostic tasks. However, a clinically relevant question that practitioners usually face, is how to predict the future trajectory of a disease (prognosis). Current methods for such a problem often require domain knowledge, and are complicated to apply. In this paper, we formulate the prognosis prediction problem as a one-to-many forecasting problem from multimodal data. Inspired by a clinical decision-making process with two agents -- a radiologist and a general practitioner, we model a prognosis prediction problem with two transformer-based components that share information between each other. The first block in this model aims to analyze the imaging data, and the second block leverages the internal representations of the first one as inputs, also fusing them with auxiliary patient data. We show the effectiveness of our method in predicting the development of structural knee osteoarthritis changes over time. Our results show that the proposed method outperforms the state-of-the-art baselines in terms of various performance metrics. In addition, we empirically show that the existence of the multi-agent transformers with depths of 2 is sufficient to achieve good performances. Our code is publicly available at https://github.com/MIPT-Oulu/CLIMAT.

Alzheimer's disease (AD) is a degenerative brain disease impairing a person's ability to perform day to day activities. The clinical manifestations of Alzheimer's disease are characterized by heterogeneity in age, disease span, progression rate, impairment of memory and cognitive abilities. Due to these variabilities, personalized care and treatment planning, as well as patient counseling about their individual progression is limited. Recent developments in machine learning to detect hidden patterns in complex, multi-dimensional datasets provides significant opportunities to address this critical need. In this work, we use unsupervised and supervised machine learning approaches for subtype identification and prediction. We apply machine learning methods to the extensive clinical observations available at the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set to identify patient subtypes and to predict disease progression. Our analysis depicts the progression space for the Alzheimer's disease into low, moderate and high disease progression zones. The proposed work will enable early detection and characterization of distinct disease subtypes based on clinical heterogeneity. We anticipate that our models will enable patient counseling, clinical trial design, and ultimately individualized clinical care.

Osteoarthritis (OA) is the most common musculoskeletal disease, which has no cure. Knee OA (KOA) is one of the highest causes of disability worldwide, and it costs billions of United States dollars to the global community. Prediction of KOA progression has been of high interest to the community for years, as it can advance treatment development through more efficient clinical trials and improve patient outcomes through more efficient healthcare utilization. Existing approaches for predicting KOA, however, are predominantly static, i.e. consider data from a single time point to predict progression many years into the future, and knee level, i.e. consider progression in a single joint only. Due to these and related reasons, these methods fail to deliver the level of predictive performance, which is sufficient to result in cost savings and better patient outcomes. Collecting extensive data from all patients on a regular basis could address the issue, but it is limited by the high cost at a population level. In this work, we propose to go beyond static prediction models in OA, and bring a novel Active Sensing (AS) approach, designed to dynamically follow up patients with the objective of maximizing the number of informative data acquisitions, while minimizing their total cost over a period of time. Our approach is based on Reinforcement Learning (RL), and it leverages a novel reward function designed specifically for AS of disease progression in more than one part of a human body. Our method is end-to-end, relies on multi-modal Deep Learning, and requires no human input at inference time. Throughout an exhaustive experimental evaluation, we show that using RL can provide a higher monetary benefit when compared to state-of-the-art baselines.

The rapid evolution of large language models (LLMs) has unlocked their capabilities in advanced reasoning tasks like mathematical problem-solving, code generation, and legal analysis. Central to this progress are inference-time reasoning algorithms, which refine outputs by exploring multiple solution paths, at the cost of increasing compute demands and response latencies. Existing serving systems fail to adapt to the scaling behaviors of these algorithms or the varying difficulty of queries, leading to inefficient resource use and unmet latency targets. We present Dynasor, a system that optimizes inference-time compute for LLM reasoning queries. Unlike traditional engines, Dynasor tracks and schedules requests within reasoning queries and uses Certaindex, a proxy that measures statistical reasoning progress based on model certainty, to guide compute allocation dynamically. Dynasor co-adapts scheduling with reasoning progress: it allocates more compute to hard queries, reduces compute for simpler ones, and terminates unpromising queries early, balancing accuracy, latency, and cost. On diverse datasets and algorithms, Dynasor reduces compute by up to 50% in batch processing and sustaining 3.3x higher query rates or 4.7x tighter latency SLOs in online serving.

There are two main barriers to using large language models (LLMs) in clinical reasoning. Firstly, while LLMs exhibit significant promise in Natural Language Processing (NLP) tasks, their performance in complex reasoning and planning falls short of expectations. Secondly, LLMs use uninterpretable methods to make clinical decisions that are fundamentally different from the clinician's cognitive processes. This leads to user distrust. In this paper, we present a multi-agent framework called ArgMed-Agents, which aims to enable LLM-based agents to make explainable clinical decision reasoning through interaction. ArgMed-Agents performs self-argumentation iterations via Argumentation Scheme for Clinical Discussion (a reasoning mechanism for modeling cognitive processes in clinical reasoning), and then constructs the argumentation process as a directed graph representing conflicting relationships. Ultimately, use symbolic solver to identify a series of rational and coherent arguments to support decision. We construct a formal model of ArgMed-Agents and present conjectures for theoretical guarantees. ArgMed-Agents enables LLMs to mimic the process of clinical argumentative reasoning by generating explanations of reasoning in a self-directed manner. The setup experiments show that ArgMed-Agents not only improves accuracy in complex clinical decision reasoning problems compared to other prompt methods, but more importantly, it provides users with decision explanations that increase their confidence.

Recently, slow-thinking reasoning systems, such as o1, have demonstrated remarkable capabilities in solving complex reasoning tasks. These systems typically engage in an extended thinking process before responding to a query, allowing them to generate more thorough, accurate, and well-reasoned solutions. These systems are primarily developed and maintained by industry, with their core techniques not publicly disclosed. In response, an increasing number of studies from the research community aim to explore the technical foundations underlying these powerful reasoning systems. Building on these prior efforts, this paper presents a reproduction report on implementing o1-like reasoning systems. We introduce an "imitate, explore, and self-improve" framework as our primary technical approach to train the reasoning model. In the initial phase, we use distilled long-form thought data to fine-tune the reasoning model, enabling it to invoke a slow-thinking mode. The model is then encouraged to explore challenging problems by generating multiple rollouts, which can result in increasingly more high-quality trajectories that lead to correct answers. Furthermore, the model undergoes self-improvement by iteratively refining its training dataset. To verify the effectiveness of this approach, we conduct extensive experiments on three challenging benchmarks. The experimental results demonstrate that our approach achieves competitive performance compared to industry-level reasoning systems on these benchmarks.

Large Language Models (LLMs) have attained human-level accuracy on medical question-answer (QA) benchmarks. However, their limitations in navigating open-ended clinical scenarios have recently been shown, raising concerns about the robustness and generalizability of LLM reasoning across diverse, real-world medical tasks. To probe potential LLM failure modes in clinical problem-solving, we present the medical abstraction and reasoning corpus (M-ARC). M-ARC assesses clinical reasoning through scenarios designed to exploit the Einstellung effect -- the fixation of thought arising from prior experience, targeting LLM inductive biases toward inflexible pattern matching from their training data rather than engaging in flexible reasoning. We find that LLMs, including current state-of-the-art o1 and Gemini models, perform poorly compared to physicians on M-ARC, often demonstrating lack of commonsense medical reasoning and a propensity to hallucinate. In addition, uncertainty estimation analyses indicate that LLMs exhibit overconfidence in their answers, despite their limited accuracy. The failure modes revealed by M-ARC in LLM medical reasoning underscore the need to exercise caution when deploying these models in clinical settings.

Recent advances in visual reasoning (VR), particularly with the aid of Large Vision-Language Models (VLMs), show promise but require access to large-scale datasets and face challenges such as high computational costs and limited generalization capabilities. Compositional visual reasoning approaches have emerged as effective strategies; however, they heavily rely on the commonsense knowledge encoded in Large Language Models (LLMs) to perform planning, reasoning, or both, without considering the effect of their decisions on the visual reasoning process, which can lead to errors or failed procedures. To address these challenges, we introduce HYDRA, a multi-stage dynamic compositional visual reasoning framework designed for reliable and incrementally progressive general reasoning. HYDRA integrates three essential modules: a planner, a Reinforcement Learning (RL) agent serving as a cognitive controller, and a reasoner. The planner and reasoner modules utilize an LLM to generate instruction samples and executable code from the selected instruction, respectively, while the RL agent dynamically interacts with these modules, making high-level decisions on selection of the best instruction sample given information from the historical state stored through a feedback loop. This adaptable design enables HYDRA to adjust its actions based on previous feedback received during the reasoning process, leading to more reliable reasoning outputs and ultimately enhancing its overall effectiveness. Our framework demonstrates state-of-the-art performance in various VR tasks on four different widely-used datasets.

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

In this work, we introduce Brain Latent Progression (BrLP), a novel spatiotemporal disease progression model based on latent diffusion. BrLP is designed to predict the evolution of diseases at the individual level on 3D brain MRIs. Existing deep generative models developed for this task are primarily data-driven and face challenges in learning disease progressions. BrLP addresses these challenges by incorporating prior knowledge from disease models to enhance the accuracy of predictions. To implement this, we propose to integrate an auxiliary model that infers volumetric changes in various brain regions. Additionally, we introduce Latent Average Stabilization (LAS), a novel technique to improve spatiotemporal consistency of the predicted progression. BrLP is trained and evaluated on a large dataset comprising 11,730 T1-weighted brain MRIs from 2,805 subjects, collected from three publicly available, longitudinal Alzheimer's Disease (AD) studies. In our experiments, we compare the MRI scans generated by BrLP with the actual follow-up MRIs available from the subjects, in both cross-sectional and longitudinal settings. BrLP demonstrates significant improvements over existing methods, with an increase of 22% in volumetric accuracy across AD-related brain regions and 43% in image similarity to the ground-truth scans. The ability of BrLP to generate conditioned 3D scans at the subject level, along with the novelty of integrating prior knowledge to enhance accuracy, represents a significant advancement in disease progression modeling, opening new avenues for precision medicine. The code of BrLP is available at the following link: https://github.com/LemuelPuglisi/BrLP.

In this paper, we introduce a simulacrum of hospital called Agent Hospital that simulates the entire process of treating illness. All patients, nurses, and doctors are autonomous agents powered by large language models (LLMs). Our central goal is to enable a doctor agent to learn how to treat illness within the simulacrum. To do so, we propose a method called MedAgent-Zero. As the simulacrum can simulate disease onset and progression based on knowledge bases and LLMs, doctor agents can keep accumulating experience from both successful and unsuccessful cases. Simulation experiments show that the treatment performance of doctor agents consistently improves on various tasks. More interestingly, the knowledge the doctor agents have acquired in Agent Hospital is applicable to real-world medicare benchmarks. After treating around ten thousand patients (real-world doctors may take over two years), the evolved doctor agent achieves a state-of-the-art accuracy of 93.06% on a subset of the MedQA dataset that covers major respiratory diseases. This work paves the way for advancing the applications of LLM-powered agent techniques in medical scenarios.

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

Achieving human-level intelligence requires refining the transition from the fast, intuitive System 1 to the slower, more deliberate System 2 reasoning. While System 1 excels in quick, heuristic decisions, System 2 relies on logical reasoning for more accurate judgments and reduced biases. Foundational Large Language Models (LLMs) excel at fast decision-making but lack the depth for complex reasoning, as they have not yet fully embraced the step-by-step analysis characteristic of true System 2 thinking. Recently, reasoning LLMs like OpenAI's o1/o3 and DeepSeek's R1 have demonstrated expert-level performance in fields such as mathematics and coding, closely mimicking the deliberate reasoning of System 2 and showcasing human-like cognitive abilities. This survey begins with a brief overview of the progress in foundational LLMs and the early development of System 2 technologies, exploring how their combination has paved the way for reasoning LLMs. Next, we discuss how to construct reasoning LLMs, analyzing their features, the core methods enabling advanced reasoning, and the evolution of various reasoning LLMs. Additionally, we provide an overview of reasoning benchmarks, offering an in-depth comparison of the performance of representative reasoning LLMs. Finally, we explore promising directions for advancing reasoning LLMs and maintain a real-time https://github.com/zzli2022/Awesome-Slow-Reason-System{GitHub Repository} to track the latest developments. We hope this survey will serve as a valuable resource to inspire innovation and drive progress in this rapidly evolving field.

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.

Biomedical knowledge is uniquely complex and structured, requiring distinct reasoning strategies compared to other scientific disciplines like physics or chemistry. Biomedical scientists do not rely on a single approach to reasoning; instead, they use various strategies, including rule-based, prototype-based, and case-based reasoning. This diversity calls for flexible approaches that accommodate multiple reasoning strategies while leveraging in-domain knowledge. We introduce KGARevion, a knowledge graph (KG) based agent designed to address the complexity of knowledge-intensive medical queries. Upon receiving a query, KGARevion generates relevant triplets by using the knowledge base of the LLM. These triplets are then verified against a grounded KG to filter out erroneous information and ensure that only accurate, relevant data contribute to the final answer. Unlike RAG-based models, this multi-step process ensures robustness in reasoning while adapting to different models of medical reasoning. Evaluations on four gold-standard medical QA datasets show that KGARevion improves accuracy by over 5.2%, outperforming 15 models in handling complex medical questions. To test its capabilities, we curated three new medical QA datasets with varying levels of semantic complexity, where KGARevion achieved a 10.4% improvement in accuracy.

Recent advancements in the field of large language models, particularly through the Chain of Thought (CoT) approach, have demonstrated significant improvements in solving complex problems. However, existing models either tend to sacrifice detailed reasoning for brevity due to user preferences, or require extensive and expensive training data to learn complicated reasoning ability, limiting their potential in solving complex tasks. To bridge this gap, following the concept of scaling test-time, we propose a simple method by encouraging models to adopt a more patient reasoning style without the need of introducing new knowledge or skills. To employ a preference optimization approach, we generate detailed reasoning processes as positive examples and simple answers as negative examples, thereby training the model to favor thoroughness in its responses. Our results demonstrate a performance increase of up to 6.7% on GSM8k with training just on a lightweight dataset.

We revisit the structure learning problem for dynamic Bayesian networks and propose a method that simultaneously estimates contemporaneous (intra-slice) and time-lagged (inter-slice) relationships between variables in a time-series. Our approach is score-based, and revolves around minimizing a penalized loss subject to an acyclicity constraint. To solve this problem, we leverage a recent algebraic result characterizing the acyclicity constraint as a smooth equality constraint. The resulting algorithm, which we call DYNOTEARS, outperforms other methods on simulated data, especially in high-dimensions as the number of variables increases. We also apply this algorithm on real datasets from two different domains, finance and molecular biology, and analyze the resulting output. Compared to state-of-the-art methods for learning dynamic Bayesian networks, our method is both scalable and accurate on real data. The simple formulation and competitive performance of our method make it suitable for a variety of problems where one seeks to learn connections between variables across time.

Reasoning system dynamics is one of the most important analytical approaches for many scientific studies. With the initial state of a system as input, the recent graph neural networks (GNNs)-based methods are capable of predicting the future state distant in time with high accuracy. Although these methods have diverse designs in modeling the coordinates and interacting forces of the system, we show that they actually share a common paradigm that learns the integration of the velocity over the interval between the initial and terminal coordinates. However, their integrand is constant w.r.t. time. Inspired by this observation, we propose a new approach to predict the integration based on several velocity estimations with Newton-Cotes formulas and prove its effectiveness theoretically. Extensive experiments on several benchmarks empirically demonstrate consistent and significant improvement compared with the state-of-the-art methods.

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

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Restless multi-armed bandits (RMAB) have demonstrated success in optimizing resource allocation for large beneficiary populations in public health settings. Unfortunately, RMAB models lack flexibility to adapt to evolving public health policy priorities. Concurrently, Large Language Models (LLMs) have emerged as adept automated planners across domains of robotic control and navigation. In this paper, we propose a Decision Language Model (DLM) for RMABs, enabling dynamic fine-tuning of RMAB policies in public health settings using human-language commands. We propose using LLMs as automated planners to (1) interpret human policy preference prompts, (2) propose reward functions as code for a multi-agent RMAB environment, and (3) iterate on the generated reward functions using feedback from grounded RMAB simulations. We illustrate the application of DLM in collaboration with ARMMAN, an India-based non-profit promoting preventative care for pregnant mothers, that currently relies on RMAB policies to optimally allocate health worker calls to low-resource populations. We conduct a technology demonstration in simulation using the Gemini Pro model, showing DLM can dynamically shape policy outcomes using only human prompts as input.

Automatic disease diagnosis has become increasingly valuable in clinical practice. The advent of large language models (LLMs) has catalyzed a paradigm shift in artificial intelligence, with growing evidence supporting the efficacy of LLMs in diagnostic tasks. Despite the increasing attention in this field, a holistic view is still lacking. Many critical aspects remain unclear, such as the diseases and clinical data to which LLMs have been applied, the LLM techniques employed, and the evaluation methods used. In this article, we perform a comprehensive review of LLM-based methods for disease diagnosis. Our review examines the existing literature across various dimensions, including disease types and associated clinical specialties, clinical data, LLM techniques, and evaluation methods. Additionally, we offer recommendations for applying and evaluating LLMs for diagnostic tasks. Furthermore, we assess the limitations of current research and discuss future directions. To our knowledge, this is the first comprehensive review for LLM-based disease diagnosis.

With the exponential growth of research facilitated by modern technology and improved accessibility, scientific discoveries have become increasingly fragmented within and across fields. This makes it challenging to assess the significance, novelty, incremental findings, and equivalent ideas between related works, particularly those from different research communities. Large language models (LLMs) have recently demonstrated strong quantitative and qualitative reasoning abilities, and multi-agent LLM debates have shown promise in handling complex reasoning tasks by exploring diverse perspectives and reasoning paths. Inspired by this, we introduce Tree-of-Debate (ToD), a framework which converts scientific papers into LLM personas that debate their respective novelties. To emphasize structured, critical reasoning rather than focusing solely on outcomes, ToD dynamically constructs a debate tree, enabling fine-grained analysis of independent novelty arguments within scholarly articles. Through experiments on scientific literature across various domains, evaluated by expert researchers, we demonstrate that ToD generates informative arguments, effectively contrasts papers, and supports researchers in their literature review.

We introduce MedXpertQA, a highly challenging and comprehensive benchmark to evaluate expert-level medical knowledge and advanced reasoning. MedXpertQA includes 4,460 questions spanning 17 specialties and 11 body systems. It includes two subsets, Text for text evaluation and MM for multimodal evaluation. Notably, MM introduces expert-level exam questions with diverse images and rich clinical information, including patient records and examination results, setting it apart from traditional medical multimodal benchmarks with simple QA pairs generated from image captions. MedXpertQA applies rigorous filtering and augmentation to address the insufficient difficulty of existing benchmarks like MedQA, and incorporates specialty board questions to improve clinical relevance and comprehensiveness. We perform data synthesis to mitigate data leakage risk and conduct multiple rounds of expert reviews to ensure accuracy and reliability. We evaluate 16 leading models on MedXpertQA. Moreover, medicine is deeply connected to real-world decision-making, providing a rich and representative setting for assessing reasoning abilities beyond mathematics and code. To this end, we develop a reasoning-oriented subset to facilitate the assessment of o1-like models.

Machine learning has successfully framed many sequential decision making problems as either supervised prediction, or optimal decision-making policy identification via reinforcement learning. In data-constrained offline settings, both approaches may fail as they assume fully optimal behavior or rely on exploring alternatives that may not exist. We introduce an inherently different approach that identifies possible "dead-ends" of a state space. We focus on the condition of patients in the intensive care unit, where a "medical dead-end" indicates that a patient will expire, regardless of all potential future treatment sequences. We postulate "treatment security" as avoiding treatments with probability proportional to their chance of leading to dead-ends, present a formal proof, and frame discovery as an RL problem. We then train three independent deep neural models for automated state construction, dead-end discovery and confirmation. Our empirical results discover that dead-ends exist in real clinical data among septic patients, and further reveal gaps between secure treatments and those that were administered.

Despite recent advancements in large language models (LLMs), their performance on complex reasoning problems requiring multi-step thinking and combining various skills is still limited. To address this, we propose a novel framework HDFlow for complex reasoning with LLMs that combines fast and slow thinking modes in an adaptive manner. Our approach consists of two key components: 1) a new approach for slow, deliberate reasoning called Dynamic Workflow, which automatically decomposes complex problems into more manageable sub-tasks and dynamically designs a workflow to assemble specialized LLM or symbolic reasoning tools to solve sub-tasks; 2) Hybrid Thinking, a general framework that dynamically combines fast and slow thinking based on problem complexity. Finally, we propose an easy-to-scale method for automatically synthesizing a large-scale dataset of 27K challenging reasoning problems for complex reasoning and a hybrid thinking tuning method that trains smaller LLMs on this dataset to internalize the fast/slow hybrid reasoning strategies. Experiments on four reasoning benchmark datasets demonstrate that our slow thinking with dynamic workflows significantly outperforms Chain-of-Thought, and hybrid thinking achieves the highest accuracy while providing an effective balance between computational efficiency and performance. Fine-tuning using our hybrid thinking approach also significantly boosts the complex reasoning capabilities of open-source language models. The results showcase the promise of slow thinking, dynamic workflows, and hybrid thinking in expanding the frontier of complex problem-solving with LLMsCode and data will be released at \url{https://github.com/wenlinyao/HDFlow.}.

Large language models (LLMs) have exhibited remarkable capabilities across various domains and tasks, pushing the boundaries of our knowledge in learning and cognition. The latest model, OpenAI's o1, stands out as the first LLM with an internalized chain-of-thought technique using reinforcement learning strategies. While it has demonstrated surprisingly strong capabilities on various general language tasks, its performance in specialized fields such as medicine remains unknown. To this end, this report provides a comprehensive exploration of o1 on different medical scenarios, examining 3 key aspects: understanding, reasoning, and multilinguality. Specifically, our evaluation encompasses 6 tasks using data from 37 medical datasets, including two newly constructed and more challenging question-answering (QA) tasks based on professional medical quizzes from the New England Journal of Medicine (NEJM) and The Lancet. These datasets offer greater clinical relevance compared to standard medical QA benchmarks such as MedQA, translating more effectively into real-world clinical utility. Our analysis of o1 suggests that the enhanced reasoning ability of LLMs may (significantly) benefit their capability to understand various medical instructions and reason through complex clinical scenarios. Notably, o1 surpasses the previous GPT-4 in accuracy by an average of 6.2% and 6.6% across 19 datasets and two newly created complex QA scenarios. But meanwhile, we identify several weaknesses in both the model capability and the existing evaluation protocols, including hallucination, inconsistent multilingual ability, and discrepant metrics for evaluation. We release our raw data and model outputs at https://ucsc-vlaa.github.io/o1_medicine/ for future research.

We address the problem of learning the dynamics of an unknown non-parametric system linking a target and a feature time series. The feature time series is measured on a sparse and irregular grid, while we have access to only a few points of the target time series. Once learned, we can use these dynamics to predict values of the target from the previous values of the feature time series. We frame this task as learning the solution map of a controlled differential equation (CDE). By leveraging the rich theory of signatures, we are able to cast this non-linear problem as a high-dimensional linear regression. We provide an oracle bound on the prediction error which exhibits explicit dependencies on the individual-specific sampling schemes. Our theoretical results are illustrated by simulations which show that our method outperforms existing algorithms for recovering the full time series while being computationally cheap. We conclude by demonstrating its potential on real-world epidemiological data.

Recent advancements in large language models (LLMs) have shown promise in medical applications such as disease diagnosis and treatment planning. However, most existing medical LLMs struggle with the advanced reasoning required for complex clinical scenarios, such as differential diagnosis or personalized treatment suggestions. We proposed FineMedLM-o1, which leverages high-quality synthetic medical data and long-form reasoning data for Supervised Fine-Tuning (SFT) and Direct Preference Optimization (DPO), enabling advanced dialogue and deep reasoning capabilities. Additionally, we introduced Test-Time Training (TTT) in the medical domain for the first time, facilitating domain adaptation and ensuring reliable, accurate reasoning. Experimental results demonstrate that FineMedLM-o1 achieves a 23% average performance improvement over prior models on key medical benchmarks. Furthermore, the introduction of TTT provides an additional 14% performance boost, highlighting its effectiveness in enhancing medical reasoning capabilities. To support this process, we also proposed a novel method for synthesizing medical dialogue. Compared to other open-source datasets, our dataset stands out as superior in both quality and complexity. The project and data will be released on GitHub.

Large Language Models (LLMs) have demonstrated impressive reasoning capabilities, yet their performance is highly dependent on the prompting strategy and model scale. While reinforcement learning and fine-tuning have been deployed to boost reasoning, these approaches incur substantial computational and data overhead. In this work, we introduce Adaptive Graph of Thoughts (AGoT), a dynamic, graph-based inference framework that enhances LLM reasoning solely at test time. Rather than relying on fixed-step methods like Chain of Thought (CoT) or Tree of Thoughts (ToT), AGoT recursively decomposes complex queries into structured subproblems, forming an dynamic directed acyclic graph (DAG) of interdependent reasoning steps. By selectively expanding only those subproblems that require further analysis, AGoT unifies the strengths of chain, tree, and graph paradigms into a cohesive framework that allocates computation where it is most needed. We validate our approach on diverse benchmarks spanning multi-hop retrieval, scientific reasoning, and mathematical problem-solving, achieving up to 46.2% improvement on scientific reasoning tasks (GPQA) - comparable to gains achieved through computationally intensive reinforcement learning approaches and outperforming state-of-the-art iterative approaches. These results suggest that dynamic decomposition and structured recursion offer a scalable, cost-effective alternative to post-training modifications, paving the way for more robust, general-purpose reasoning in LLMs.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

While recent advancements in commercial large language models (LM) have shown promising results in medical tasks, their closed-source nature poses significant privacy and security concerns, hindering their widespread use in the medical field. Despite efforts to create open-source models, their limited parameters often result in insufficient multi-step reasoning capabilities required for solving complex medical problems. To address this, we introduce Meerkat-7B, a novel medical AI system with 7 billion parameters. Meerkat-7B was trained using our new synthetic dataset consisting of high-quality chain-of-thought reasoning paths sourced from 18 medical textbooks, along with diverse instruction-following datasets. Our system achieved remarkable accuracy across seven medical benchmarks, surpassing GPT-3.5 by 13.1%, as well as outperforming the previous best 7B models such as MediTron-7B and BioMistral-7B by 13.4% and 9.8%, respectively. Notably, it surpassed the passing threshold of the United States Medical Licensing Examination (USMLE) for the first time for a 7B-parameter model. Additionally, our system offered more detailed free-form responses to clinical queries compared to existing 7B and 13B models, approaching the performance level of GPT-3.5. This significantly narrows the performance gap with large LMs, showcasing its effectiveness in addressing complex medical challenges.

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

Rare diseases present unique challenges in healthcare, often suffering from delayed diagnosis and fragmented information landscapes. The scarcity of reliable knowledge in these conditions poses a distinct challenge for Large Language Models (LLMs) in supporting clinical management and delivering precise patient information underscoring the need for focused training on these 'zebra' cases. We present Zebra-Llama, a specialized context-aware language model with high precision Retrieval Augmented Generation (RAG) capability, focusing on Ehlers-Danlos Syndrome (EDS) as our case study. EDS, affecting 1 in 5,000 individuals, exemplifies the complexities of rare diseases with its diverse symptoms, multiple subtypes, and evolving diagnostic criteria. By implementing a novel context-aware fine-tuning methodology trained on questions derived from medical literature, patient experiences, and clinical resources, along with expertly curated responses, Zebra-Llama demonstrates unprecedented capabilities in handling EDS-related queries. On a test set of real-world questions collected from EDS patients and clinicians, medical experts evaluated the responses generated by both models, revealing Zebra-Llama's substantial improvements over base model (Llama 3.1-8B-Instruct) in thoroughness (77.5% vs. 70.1%), accuracy (83.0% vs. 78.8%), clarity (74.7% vs. 72.0%) and citation reliability (70.6% vs. 52.3%). Released as an open-source resource, Zebra-Llama not only provides more accessible and reliable EDS information but also establishes a framework for developing specialized AI solutions for other rare conditions. This work represents a crucial step towards democratizing expert-level knowledge in rare disease management, potentially transforming how healthcare providers and patients navigate the complex landscape of rare diseases.

Table-based reasoning with large language models (LLMs) is a promising direction to tackle many table understanding tasks, such as table-based question answering and fact verification. Compared with generic reasoning, table-based reasoning requires the extraction of underlying semantics from both free-form questions and semi-structured tabular data. Chain-of-Thought and its similar approaches incorporate the reasoning chain in the form of textual context, but it is still an open question how to effectively leverage tabular data in the reasoning chain. We propose the Chain-of-Table framework, where tabular data is explicitly used in the reasoning chain as a proxy for intermediate thoughts. Specifically, we guide LLMs using in-context learning to iteratively generate operations and update the table to represent a tabular reasoning chain. LLMs can therefore dynamically plan the next operation based on the results of the previous ones. This continuous evolution of the table forms a chain, showing the reasoning process for a given tabular problem. The chain carries structured information of the intermediate results, enabling more accurate and reliable predictions. Chain-of-Table achieves new state-of-the-art performance on WikiTQ, FeTaQA, and TabFact benchmarks across multiple LLM choices.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

Mediation analysis learns the causal effect transmitted via mediator variables between treatments and outcomes and receives increasing attention in various scientific domains to elucidate causal relations. Most existing works focus on point-exposure studies where each subject only receives one treatment at a single time point. However, there are a number of applications (e.g., mobile health) where the treatments are sequentially assigned over time and the dynamic mediation effects are of primary interest. Proposing a reinforcement learning (RL) framework, we are the first to evaluate dynamic mediation effects in settings with infinite horizons. We decompose the average treatment effect into an immediate direct effect, an immediate mediation effect, a delayed direct effect, and a delayed mediation effect. Upon the identification of each effect component, we further develop robust and semi-parametrically efficient estimators under the RL framework to infer these causal effects. The superior performance of the proposed method is demonstrated through extensive numerical studies, theoretical results, and an analysis of a mobile health dataset.

Brain tumor growth is unique to each glioma patient and extends beyond what is visible in imaging scans, infiltrating surrounding brain tissue. Understanding these hidden patient-specific progressions is essential for effective therapies. Current treatment plans for brain tumors, such as radiotherapy, typically involve delineating a uniform margin around the visible tumor on pre-treatment scans to target this invisible tumor growth. This "one size fits all" approach is derived from population studies and often fails to account for the nuances of individual patient conditions. We present the GliODIL framework, which infers the full spatial distribution of tumor cell concentration from available multi-modal imaging, leveraging a Fisher-Kolmogorov type physics model to describe tumor growth. This is achieved through the newly introduced method of Optimizing the Discrete Loss (ODIL), where both data and physics-based constraints are softly assimilated into the solution. Our test dataset comprises 152 glioblastoma patients with pre-treatment imaging and post-treatment follow-ups for tumor recurrence monitoring. By blending data-driven techniques with physics-based constraints, GliODIL enhances recurrence prediction in radiotherapy planning, challenging traditional uniform margins and strict adherence to the Fisher-Kolmogorov partial differential equation (PDE) model, which is adapted for complex cases.

Deep iterative chain-of-thought (CoT) reasoning enables LLMs to tackle complex tasks by progressively activating relevant pre-trained knowledge. However, it faces challenges in ensuring continual improvement and determining a stopping criterion. In this paper, we investigate whether the relevant knowledge that contributes directly to solving the given question can be activated from the initial reasoning path, thus circumventing the need for iterative refinement. Our experiments reveal that increasing the diversity of initial reasoning paths can achieve comparable or superior performance, a concept we term breadth reasoning. However, existing breadth reasoning approaches, such as self-consistency, offer limited diversity. To address this limitation, we propose a simple yet effective method that enhances reasoning breadth by integrating contextual exploration with reduced sampling randomness. Extensive experiments demonstrate that our approach significantly outperforms deep iterative reasoning. Our code is provided in https://github.com/zongqianwu/breadth.

The advancement in generative AI could be boosted with more accessible mathematics. Beyond human-AI chat, large language models (LLMs) are emerging in programming, algorithm discovery, and theorem proving, yet their genomics application is limited. This project introduces Math Agents and mathematical embedding as fresh entries to the "Moore's Law of Mathematics", using a GPT-based workflow to convert equations from literature into LaTeX and Python formats. While many digital equation representations exist, there's a lack of automated large-scale evaluation tools. LLMs are pivotal as linguistic user interfaces, providing natural language access for human-AI chat and formal languages for large-scale AI-assisted computational infrastructure. Given the infinite formal possibility spaces, Math Agents, which interact with math, could potentially shift us from "big data" to "big math". Math, unlike the more flexible natural language, has properties subject to proof, enabling its use beyond traditional applications like high-validation math-certified icons for AI alignment aims. This project aims to use Math Agents and mathematical embeddings to address the ageing issue in information systems biology by applying multiscalar physics mathematics to disease models and genomic data. Generative AI with episodic memory could help analyse causal relations in longitudinal health records, using SIR Precision Health models. Genomic data is suggested for addressing the unsolved Alzheimer's disease problem.

Enhancing the capability of large language models (LLMs) in reasoning has gained significant attention in recent years. Previous studies have demonstrated the effectiveness of various prompting strategies in aiding LLMs in reasoning (called "reasoning actions"), such as step-by-step thinking, reflecting before answering, solving with programs, and their combinations. However, these approaches often applied static, predefined reasoning actions uniformly to all questions, without considering the specific characteristics of each question or the capability of the task-solving LLM. In this paper, we propose DOTS, an approach enabling LLMs to reason dynamically via optimal reasoning trajectory search, tailored to the specific characteristics of each question and the inherent capability of the task-solving LLM. Our approach involves three key steps: i) defining atomic reasoning action modules that can be composed into various reasoning action trajectories; ii) searching for the optimal action trajectory for each training question through iterative exploration and evaluation for the specific task-solving LLM; and iii) using the collected optimal trajectories to train an LLM to plan for the reasoning trajectories of unseen questions. In particular, we propose two learning paradigms, i.e., fine-tuning an external LLM as a planner to guide the task-solving LLM, or directly fine-tuning the task-solving LLM with an internalized capability for reasoning actions planning. Our experiments across eight reasoning tasks show that our method consistently outperforms static reasoning techniques and the vanilla instruction tuning approach. Further analysis reveals that our method enables LLMs to adjust their computation based on problem complexity, allocating deeper thinking and reasoning to harder problems.

To enable Large Language Models (LLMs) to function as conscious agents with generalizable reasoning capabilities, it is crucial that they possess the reasoning ability to comprehend situational changes (transitions) in distribution triggered by environmental factors or actions from other agents. Despite its fundamental significance, this ability remains underexplored due to the complexity of modeling infinite possible changes in an event and their associated distributions, coupled with the lack of benchmark data with situational transitions. Addressing these gaps, we propose a novel formulation of reasoning with distributional changes as a three-step discriminative process, termed as MetAphysical ReaSoning. We then introduce the first-ever benchmark, MARS, comprising three tasks corresponding to each step. These tasks systematically assess LLMs' capabilities in reasoning the plausibility of (i) changes in actions, (ii) states caused by changed actions, and (iii) situational transitions driven by changes in action. Extensive evaluations with 20 (L)LMs of varying sizes and methods indicate that all three tasks in this process pose significant challenges, even for state-of-the-art LLMs and LMs after fine-tuning. Further analyses reveal potential causes for the underperformance of LLMs and demonstrate that pre-training them on large-scale conceptualization taxonomies can potentially enhance their metaphysical reasoning capabilities. Our data and models are publicly accessible at https://github.com/HKUST-KnowComp/MARS.

Heart disease, also known as cardiovascular disease, is a prevalent and critical medical condition characterized by the impairment of the heart and blood vessels, leading to various complications such as coronary artery disease, heart failure, and myocardial infarction. The timely and accurate detection of heart disease is of paramount importance in clinical practice. Early identification of individuals at risk enables proactive interventions, preventive measures, and personalized treatment strategies to mitigate the progression of the disease and reduce adverse outcomes. In recent years, the field of heart disease detection has witnessed notable advancements due to the integration of sophisticated technologies and computational approaches. These include machine learning algorithms, data mining techniques, and predictive modeling frameworks that leverage vast amounts of clinical and physiological data to improve diagnostic accuracy and risk stratification. In this work, we propose to detect heart disease from ECG images using cutting-edge technologies, namely vision transformer models. These models are Google-Vit, Microsoft-Beit, and Swin-Tiny. To the best of our knowledge, this is the initial endeavor concentrating on the detection of heart diseases through image-based ECG data by employing cuttingedge technologies namely, transformer models. To demonstrate the contribution of the proposed framework, the performance of vision transformer models are compared with state-of-the-art studies. Experiment results show that the proposed framework exhibits remarkable classification results.

Large Language Models (LLMs) achieve superior performance through training-time scaling, and test-time scaling further enhances their capabilities by conducting effective reasoning during inference. However, as the scale of reasoning increases, existing test-time scaling methods suffer from accumulated historical information, which not only wastes computational resources but also interferes with effective reasoning. To address this issue, we observe that complex reasoning progress is often achieved by solving a sequence of independent subquestions, each being self-contained and verifiable. These subquestions are essentially atomic questions, relying primarily on their current state rather than accumulated history, similar to the memoryless transitions in a Markov process. Based on this observation, we propose Atom of Thoughts (AoT), where each state transition in the reasoning process consists of decomposing the current question into a dependency-based directed acyclic graph and contracting its subquestions, forming a new atomic question state. This iterative decomposition-contraction process continues until reaching directly solvable atomic questions, naturally realizing Markov transitions between question states. Furthermore, these atomic questions can be seamlessly integrated into existing test-time scaling methods, enabling AoT to serve as a plug-in enhancement for improving reasoning capabilities. Experiments across six benchmarks demonstrate the effectiveness of AoT both as a standalone framework and a plug-in enhancement. Notably, on HotpotQA, when applied to gpt-4o-mini, AoT achieves an 80.6% F1 score, surpassing o3-mini by 3.4% and DeepSeek-R1 by 10.6%. The code will be available at https://github.com/qixucen/atom.

The drug development pipeline for a new compound can last 10-20 years and cost over 10 billion. Drug repurposing offers a more time- and cost-effective alternative. Computational approaches based on biomedical knowledge graph representations have recently yielded new drug repurposing hypotheses. In this study, we present a novel, disease-specific hypergraph representation learning technique to derive contextual embeddings of biological pathways of various lengths but that all start at any given drug and all end at the disease of interest. Further, we extend this method to multi-disease hypergraphs. To determine the repurposing potential of each of the 1,522 drugs, we derive drug-specific distributions of cosine similarity values and ultimately consider the median for ranking. Cosine similarity values are computed between (1) all biological pathways starting at the considered drug and ending at the disease of interest and (2) all biological pathways starting at drugs currently prescribed against that disease and ending at the disease of interest. We illustrate our approach with Alzheimer's disease (AD) and two of its risk factors: hypertension (HTN) and type 2 diabetes (T2D). We compare each drug's rank across four hypergraph settings (single- or multi-disease): AD only, AD + HTN, AD + T2D, and AD + HTN + T2D. Notably, our framework led to the identification of two promising drugs whose repurposing potential was significantly higher in hypergraphs combining two diseases: dapagliflozin (antidiabetic; moved up, from top 32% to top 7%, across all considered drugs) and debrisoquine (antihypertensive; moved up, from top 76% to top 23%). Our approach serves as a hypothesis generation tool, to be paired with a validation pipeline relying on laboratory experiments and semi-automated parsing of the biomedical literature.

In the absence of extensive human-annotated data for complex reasoning tasks, self-improvement -- where models are trained on their own outputs -- has emerged as a primary method for enhancing performance. However, the critical factors underlying the mechanism of these iterative self-improving methods remain poorly understood, such as under what conditions self-improvement is effective, and what are the bottlenecks in the current iterations. In this work, we identify and propose methods to monitor two pivotal factors in this iterative process: (1) the model's ability to generate sufficiently diverse responses (exploration); and (2) the effectiveness of external rewards in distinguishing high-quality candidates from lower-quality ones (exploitation). Using mathematical reasoning as a case study, we begin with a quantitative analysis to track the dynamics of exploration and exploitation, discovering that a model's exploratory capabilities rapidly deteriorate over iterations, and the effectiveness of exploiting external rewards diminishes as well. Motivated by these findings, we introduce B-STaR, a Self-Taught Reasoning framework that autonomously adjusts configurations across iterations to Balance exploration and exploitation, thereby optimizing the self-improving effectiveness based on the current policy model and available rewards. Our experiments on mathematical reasoning, coding, and commonsense reasoning demonstrate that B-STaR not only enhances the model's exploratory capabilities throughout training but also achieves a more effective balance between exploration and exploitation, leading to superior performance.

With the increasing availability of structured and unstructured data and the swift progress of analytical techniques, Artificial Intelligence (AI) is bringing a revolution to the healthcare industry. With the increasingly indispensable role of AI in healthcare, there are growing concerns over the lack of transparency and explainability in addition to potential bias encountered by predictions of the model. This is where Explainable Artificial Intelligence (XAI) comes into the picture. XAI increases the trust placed in an AI system by medical practitioners as well as AI researchers, and thus, eventually, leads to an increasingly widespread deployment of AI in healthcare. In this paper, we present different interpretability techniques. The aim is to enlighten practitioners on the understandability and interpretability of explainable AI systems using a variety of techniques available which can be very advantageous in the health-care domain. Medical diagnosis model is responsible for human life and we need to be confident enough to treat a patient as instructed by a black-box model. Our paper contains examples based on the heart disease dataset and elucidates on how the explainability techniques should be preferred to create trustworthiness while using AI systems in healthcare.

Real-world deployment of machine learning models is challenging because data evolves over time. While no model can work when data evolves in an arbitrary fashion, if there is some pattern to these changes, we might be able to design methods to address it. This paper addresses situations when data evolves gradually. We introduce a time-varying propensity score that can detect gradual shifts in the distribution of data which allows us to selectively sample past data to update the model -- not just similar data from the past like that of a standard propensity score but also data that evolved in a similar fashion in the past. The time-varying propensity score is quite general: we demonstrate different ways of implementing it and evaluate it on a variety of problems ranging from supervised learning (e.g., image classification problems) where data undergoes a sequence of gradual shifts, to reinforcement learning tasks (e.g., robotic manipulation and continuous control) where data shifts as the policy or the task changes.

We address causal reasoning in multivariate time series data generated by stochastic processes. Existing approaches are largely restricted to static settings, ignoring the continuity and emission of variations across time. In contrast, we propose a learning paradigm that directly establishes causation between events in the course of time. We present two key lemmas to compute causal contributions and frame them as reinforcement learning problems. Our approach offers formal and computational tools for uncovering and quantifying causal relationships in diffusion processes, subsuming various important settings such as discrete-time Markov decision processes. Finally, in fairly intricate experiments and through sheer learning, our framework reveals and quantifies causal links, which otherwise seem inexplicable.

Inspired by the success of DeepSeek-R1, we explore the potential of rule-based reinforcement learning (RL) in large reasoning models. To analyze reasoning dynamics, we use synthetic logic puzzles as training data due to their controllable complexity and straightforward answer verification. We make some key technical contributions that lead to effective and stable RL training: a system prompt that emphasizes the thinking and answering process, a stringent format reward function that penalizes outputs for taking shortcuts, and a straightforward training recipe that achieves stable convergence. Our 7B model develops advanced reasoning skills-such as reflection, verification, and summarization-that are absent from the logic corpus. Remarkably, after training on just 5K logic problems, it demonstrates generalization abilities to the challenging math benchmarks AIME and AMC.

Machine learning models are often trained to predict the outcome resulting from a human decision. For example, if a doctor decides to test a patient for disease, will the patient test positive? A challenge is that historical decision-making determines whether the outcome is observed: we only observe test outcomes for patients doctors historically tested. Untested patients, for whom outcomes are unobserved, may differ from tested patients along observed and unobserved dimensions. We propose a Bayesian model class which captures this setting. The purpose of the model is to accurately estimate risk for both tested and untested patients. Estimating this model is challenging due to the wide range of possibilities for untested patients. To address this, we propose two domain constraints which are plausible in health settings: a prevalence constraint, where the overall disease prevalence is known, and an expertise constraint, where the human decision-maker deviates from purely risk-based decision-making only along a constrained feature set. We show theoretically and on synthetic data that domain constraints improve parameter inference. We apply our model to a case study of cancer risk prediction, showing that the model's inferred risk predicts cancer diagnoses, its inferred testing policy captures known public health policies, and it can identify suboptimalities in test allocation. Though our case study is in healthcare, our analysis reveals a general class of domain constraints which can improve model estimation in many settings.

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

We develop a novel, general and computationally efficient framework, called Divide and Conquer Dynamic Programming (DCDP), for localizing change points in time series data with high-dimensional features. DCDP deploys a class of greedy algorithms that are applicable to a broad variety of high-dimensional statistical models and can enjoy almost linear computational complexity. We investigate the performance of DCDP in three commonly studied change point settings in high dimensions: the mean model, the Gaussian graphical model, and the linear regression model. In all three cases, we derive non-asymptotic bounds for the accuracy of the DCDP change point estimators. We demonstrate that the DCDP procedures consistently estimate the change points with sharp, and in some cases, optimal rates while incurring significantly smaller computational costs than the best available algorithms. Our findings are supported by extensive numerical experiments on both synthetic and real data.

Models that can predict the occurrence of events ahead of time with low false-alarm rates are critical to the acceptance of decision support systems in the medical community. This challenging task is typically treated as a simple binary classification, ignoring temporal dependencies between samples, whereas we propose to exploit this structure. We first introduce a common theoretical framework unifying dynamic survival analysis and early event prediction. Following an analysis of objectives from both fields, we propose Temporal Label Smoothing (TLS), a simpler, yet best-performing method that preserves prediction monotonicity over time. By focusing the objective on areas with a stronger predictive signal, TLS improves performance over all baselines on two large-scale benchmark tasks. Gains are particularly notable along clinically relevant measures, such as event recall at low false-alarm rates. TLS reduces the number of missed events by up to a factor of two over previously used approaches in early event prediction.

Reasoning, as an essential ability for complex problem-solving, can provide back-end support for various real-world applications, such as medical diagnosis, negotiation, etc. This paper provides a comprehensive survey of cutting-edge research on reasoning with language model prompting. We introduce research works with comparisons and summaries and provide systematic resources to help beginners. We also discuss the potential reasons for emerging such reasoning abilities and highlight future research directions. Resources are available at https://github.com/zjunlp/Prompt4ReasoningPapers (updated periodically).

Quantitative tools are increasingly appealing for decision support in healthcare, driven by the growing capabilities of advanced AI systems. However, understanding the predictive uncertainties surrounding a tool's output is crucial for decision-makers to ensure reliable and transparent decisions. In this paper, we present a case study on pulmonary nodule detection for lung cancer screening, enhancing an advanced detection model with an uncertainty quantification technique called conformal risk control (CRC). We demonstrate that prediction sets with conformal guarantees are attractive measures of predictive uncertainty in the safety-critical healthcare domain, allowing end-users to achieve arbitrary validity by trading off false positives and providing formal statistical guarantees on model performance. Among ground-truth nodules annotated by at least three radiologists, our model achieves a sensitivity that is competitive with that generally achieved by individual radiologists, with a slight increase in false positives. Furthermore, we illustrate the risks of using off-the-shelve prediction models when faced with ontological uncertainty, such as when radiologists disagree on what constitutes the ground truth on pulmonary nodules.

The reasoning abilities of large language models (LLMs) have improved with chain-of-thought (CoT) prompting, allowing models to solve complex tasks in a stepwise manner. However, training CoT capabilities requires detailed reasoning data, which is often scarce. The self-taught reasoner (STaR) framework addresses this by using reinforcement learning to automatically generate reasoning steps, reducing reliance on human-labeled data. Although STaR and its variants have demonstrated empirical success, a theoretical foundation explaining these improvements is lacking. This work provides a theoretical framework for understanding the effectiveness of reinforcement learning on CoT reasoning and STaR. Our contributions are: (1) an analysis of policy improvement, showing why LLM reasoning improves iteratively with STaR; (2) conditions for convergence to an optimal reasoning policy; (3) an examination of STaR's robustness, explaining how it can improve reasoning even when incorporating occasional incorrect steps; and (4) criteria for the quality of pre-trained models necessary to initiate effective reasoning improvement. This framework aims to bridge empirical findings with theoretical insights, advancing reinforcement learning approaches for reasoning in LLMs.

The acute phase of the Covid-19 pandemic has made apparent the need for decision support based upon accurate epidemic modeling. This process is substantially hampered by under-reporting of cases and related data incompleteness issues. In this article we adopt the Bayesian paradigm and synthesize publicly available data via a discrete-time stochastic epidemic modeling framework. The models allow for estimating the total number of infections while accounting for the endemic phase of the pandemic. We assess the prediction of the infection rate utilizing mobility information, notably the principal components of the mobility data. We evaluate variational Bayes in this context and find that Hamiltonian Monte Carlo offers a robust inference alternative for such models. We elaborate upon vector analysis of the epidemic dynamics, thus enriching the traditional tools used for decision making. In particular, we show how certain 2-dimensional plots on the phase plane may yield intuitive information regarding the speed and the type of transmission dynamics. We investigate the potential of a two-stage analysis as a consequence of cutting feedback, for inference on certain functionals of the model parameters. Finally, we show that a point mass on critical parameters is overly restrictive and investigate informative priors as a suitable alternative.

Commonsense causality reasoning (CCR) aims at identifying plausible causes and effects in natural language descriptions that are deemed reasonable by an average person. Although being of great academic and practical interest, this problem is still shadowed by the lack of a well-posed theoretical framework; existing work usually relies on deep language models wholeheartedly, and is potentially susceptible to confounding co-occurrences. Motivated by classical causal principles, we articulate the central question of CCR and draw parallels between human subjects in observational studies and natural languages to adopt CCR to the potential-outcomes framework, which is the first such attempt for commonsense tasks. We propose a novel framework, ROCK, to Reason O(A)bout Commonsense K(C)ausality, which utilizes temporal signals as incidental supervision, and balances confounding effects using temporal propensities that are analogous to propensity scores. The ROCK implementation is modular and zero-shot, and demonstrates good CCR capabilities.

Artificial intelligence has advanced in Medical Visual Question Answering (Med-VQA), but prevalent research tends to focus on the accuracy of the answers, often overlooking the reasoning paths and interpretability, which are crucial in clinical settings. Besides, current Med-VQA algorithms, typically reliant on singular models, lack the robustness needed for real-world medical diagnostics which usually require collaborative expert evaluation. To address these shortcomings, this paper presents MedCoT, a novel hierarchical expert verification reasoning chain method designed to enhance interpretability and accuracy in biomedical imaging inquiries. MedCoT is predicated on two principles: The necessity for explicit reasoning paths in Med-VQA and the requirement for multi-expert review to formulate accurate conclusions. The methodology involves an Initial Specialist proposing diagnostic rationales, followed by a Follow-up Specialist who validates these rationales, and finally, a consensus is reached through a vote among a sparse Mixture of Experts within the locally deployed Diagnostic Specialist, which then provides the definitive diagnosis. Experimental evaluations on four standard Med-VQA datasets demonstrate that MedCoT surpasses existing state-of-the-art approaches, providing significant improvements in performance and interpretability.

Recently, diffusion models have garnered significant interest in the field of text processing due to their many potential advantages compared to conventional autoregressive models. In this work, we propose Diffusion-of-Thought (DoT), a novel approach that integrates diffusion models with Chain-of-Thought, a well-established technique for improving the reasoning ability of autoregressive language models. In contrast to autoregressive language models that make decisions in a left-to-right, token-by-token manner, DoT allows reasoning steps to diffuse over time through a diffusion language model and offers greater flexibility in trading-off computation for reasoning performance. Our experimental results demonstrate the effectiveness of DoT in multi-digit multiplication, boolean logic, and grade school math problems, with a small diffusion model outperforming a much larger autoregressive model in both efficiency and accuracy. In addition to that, DoT showcases promising self-correction abilities and benefits from existing reasoning-enhancing techniques like self-consistency decoding. Our findings contribute to the understanding and development of reasoning with diffusion language models.

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

This paper introduces Typhoon T1, an open effort to develop an open Thai reasoning model. A reasoning model is a relatively new type of generative model built on top of large language models (LLMs). A reasoning model generates a long chain of thought before arriving at a final answer, an approach found to improve performance on complex tasks. However, details on developing such a model are limited, especially for reasoning models that can generate traces in a low-resource language. Typhoon T1 presents an open effort that dives into the details of developing a reasoning model in a more cost-effective way by leveraging supervised fine-tuning using open datasets, instead of reinforcement learning. This paper shares the details about synthetic data generation and training, as well as our dataset and model weights. Additionally, we provide insights gained from developing a reasoning model that generalizes across domains and is capable of generating reasoning traces in a low-resource language, using Thai as an example. We hope this open effort provides a foundation for further research in this field.

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

Machine learning (ML) has the potential to revolutionize various domains, but its adoption is often hindered by the disconnect between the needs of domain experts and translating these needs into robust and valid ML tools. Despite recent advances in LLM-based co-pilots to democratize ML for non-technical domain experts, these systems remain predominantly focused on model-centric aspects while overlooking critical data-centric challenges. This limitation is problematic in complex real-world settings where raw data often contains complex issues, such as missing values, label noise, and domain-specific nuances requiring tailored handling. To address this we introduce CliMB-DC, a human-guided, data-centric framework for LLM co-pilots that combines advanced data-centric tools with LLM-driven reasoning to enable robust, context-aware data processing. At its core, CliMB-DC introduces a novel, multi-agent reasoning system that combines a strategic coordinator for dynamic planning and adaptation with a specialized worker agent for precise execution. Domain expertise is then systematically incorporated to guide the reasoning process using a human-in-the-loop approach. To guide development, we formalize a taxonomy of key data-centric challenges that co-pilots must address. Thereafter, to address the dimensions of the taxonomy, we integrate state-of-the-art data-centric tools into an extensible, open-source architecture, facilitating the addition of new tools from the research community. Empirically, using real-world healthcare datasets we demonstrate CliMB-DC's ability to transform uncurated datasets into ML-ready formats, significantly outperforming existing co-pilot baselines for handling data-centric challenges. CliMB-DC promises to empower domain experts from diverse domains -- healthcare, finance, social sciences and more -- to actively participate in driving real-world impact using ML.

Run-time steering strategies like Medprompt are valuable for guiding large language models (LLMs) to top performance on challenging tasks. Medprompt demonstrates that a general LLM can be focused to deliver state-of-the-art performance on specialized domains like medicine by using a prompt to elicit a run-time strategy involving chain of thought reasoning and ensembling. OpenAI's o1-preview model represents a new paradigm, where a model is designed to do run-time reasoning before generating final responses. We seek to understand the behavior of o1-preview on a diverse set of medical challenge problem benchmarks. Following on the Medprompt study with GPT-4, we systematically evaluate the o1-preview model across various medical benchmarks. Notably, even without prompting techniques, o1-preview largely outperforms the GPT-4 series with Medprompt. We further systematically study the efficacy of classic prompt engineering strategies, as represented by Medprompt, within the new paradigm of reasoning models. We found that few-shot prompting hinders o1's performance, suggesting that in-context learning may no longer be an effective steering approach for reasoning-native models. While ensembling remains viable, it is resource-intensive and requires careful cost-performance optimization. Our cost and accuracy analysis across run-time strategies reveals a Pareto frontier, with GPT-4o representing a more affordable option and o1-preview achieving state-of-the-art performance at higher cost. Although o1-preview offers top performance, GPT-4o with steering strategies like Medprompt retains value in specific contexts. Moreover, we note that the o1-preview model has reached near-saturation on many existing medical benchmarks, underscoring the need for new, challenging benchmarks. We close with reflections on general directions for inference-time computation with LLMs.

Digital twin technology has is anticipated to transform healthcare, enabling personalized medicines and support, earlier diagnoses, simulated treatment outcomes, and optimized surgical plans. Digital twins are readily gaining traction in industries like manufacturing, supply chain logistics, and civil infrastructure. Not in patient care, however. The challenge of modeling complex diseases with multimodal patient data and the computational complexities of analyzing it have stifled digital twin adoption in the biomedical vertical. Yet, these major obstacles can potentially be handled by approaching these models in a different way. This paper proposes a novel framework for addressing the barriers to clinical twin modeling created by computational costs and modeling complexities. We propose structuring patient health data as a knowledge graph and using closed-form continuous-time liquid neural networks, for real-time analytics. By synthesizing multimodal patient data and leveraging the flexibility and efficiency of closed form continuous time networks and knowledge graph ontologies, our approach enables real time insights, personalized medicine, early diagnosis and intervention, and optimal surgical planning. This novel approach provides a comprehensive and adaptable view of patient health along with real-time analytics, paving the way for digital twin simulations and other anticipated benefits in healthcare.

Explaining Artificial Intelligence (AI) decisions is a major challenge nowadays in AI, in particular when applied to sensitive scenarios like medicine and law. However, the need to explain the rationale behind decisions is a main issue also for human-based deliberation as it is important to justify why a certain decision has been taken. Resident medical doctors for instance are required not only to provide a (possibly correct) diagnosis, but also to explain how they reached a certain conclusion. Developing new tools to aid residents to train their explanation skills is therefore a central objective of AI in education. In this paper, we follow this direction, and we present, to the best of our knowledge, the first multilingual dataset for Medical Question Answering where correct and incorrect diagnoses for a clinical case are enriched with a natural language explanation written by doctors. These explanations have been manually annotated with argument components (i.e., premise, claim) and argument relations (i.e., attack, support), resulting in the Multilingual CasiMedicos-Arg dataset which consists of 558 clinical cases in four languages (English, Spanish, French, Italian) with explanations, where we annotated 5021 claims, 2313 premises, 2431 support relations, and 1106 attack relations. We conclude by showing how competitive baselines perform over this challenging dataset for the argument mining task.

Mathematical reasoning---a core ability within human intelligence---presents some unique challenges as a domain: we do not come to understand and solve mathematical problems primarily on the back of experience and evidence, but on the basis of inferring, learning, and exploiting laws, axioms, and symbol manipulation rules. In this paper, we present a new challenge for the evaluation (and eventually the design) of neural architectures and similar system, developing a task suite of mathematics problems involving sequential questions and answers in a free-form textual input/output format. The structured nature of the mathematics domain, covering arithmetic, algebra, probability and calculus, enables the construction of training and test splits designed to clearly illuminate the capabilities and failure-modes of different architectures, as well as evaluate their ability to compose and relate knowledge and learned processes. Having described the data generation process and its potential future expansions, we conduct a comprehensive analysis of models from two broad classes of the most powerful sequence-to-sequence architectures and find notable differences in their ability to resolve mathematical problems and generalize their knowledge.

Retrieval-augmented generation (RAG) is a well-suited technique for retrieving privacy-sensitive Electronic Health Records (EHR). It can serve as a key module of the healthcare copilot, helping reduce misdiagnosis for healthcare practitioners and patients. However, the diagnostic accuracy and specificity of existing heuristic-based RAG models used in the medical domain are inadequate, particularly for diseases with similar manifestations. This paper proposes MedRAG, a RAG model enhanced by knowledge graph (KG)-elicited reasoning for the medical domain that retrieves diagnosis and treatment recommendations based on manifestations. MedRAG systematically constructs a comprehensive four-tier hierarchical diagnostic KG encompassing critical diagnostic differences of various diseases. These differences are dynamically integrated with similar EHRs retrieved from an EHR database, and reasoned within a large language model. This process enables more accurate and specific decision support, while also proactively providing follow-up questions to enhance personalized medical decision-making. MedRAG is evaluated on both a public dataset DDXPlus and a private chronic pain diagnostic dataset (CPDD) collected from Tan Tock Seng Hospital, and its performance is compared against various existing RAG methods. Experimental results show that, leveraging the information integration and relational abilities of the KG, our MedRAG provides more specific diagnostic insights and outperforms state-of-the-art models in reducing misdiagnosis rates. Our code will be available at https://github.com/SNOWTEAM2023/MedRAG

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

After being collected for patient care, Observational Health Data (OHD) can further benefit patient well-being by sustaining the development of health informatics and medical research. Vast potential is unexploited because of the fiercely private nature of patient-related data and regulations to protect it. Generative Adversarial Networks (GANs) have recently emerged as a groundbreaking way to learn generative models that produce realistic synthetic data. They have revolutionized practices in multiple domains such as self-driving cars, fraud detection, digital twin simulations in industrial sectors, and medical imaging. The digital twin concept could readily apply to modelling and quantifying disease progression. In addition, GANs posses many capabilities relevant to common problems in healthcare: lack of data, class imbalance, rare diseases, and preserving privacy. Unlocking open access to privacy-preserving OHD could be transformative for scientific research. In the midst of COVID-19, the healthcare system is facing unprecedented challenges, many of which of are data related for the reasons stated above. Considering these facts, publications concerning GAN applied to OHD seemed to be severely lacking. To uncover the reasons for this slow adoption, we broadly reviewed the published literature on the subject. Our findings show that the properties of OHD were initially challenging for the existing GAN algorithms (unlike medical imaging, for which state-of-the-art model were directly transferable) and the evaluation synthetic data lacked clear metrics. We find more publications on the subject than expected, starting slowly in 2017, and since then at an increasing rate. The difficulties of OHD remain, and we discuss issues relating to evaluation, consistency, benchmarking, data modelling, and reproducibility.

Research is a fundamental process driving the advancement of human civilization, yet it demands substantial time and effort from researchers. In recent years, the rapid development of artificial intelligence (AI) technologies has inspired researchers to explore how AI can accelerate and enhance research. To monitor relevant advancements, this paper presents a systematic review of the progress in this domain. Specifically, we organize the relevant studies into three main categories: hypothesis formulation, hypothesis validation, and manuscript publication. Hypothesis formulation involves knowledge synthesis and hypothesis generation. Hypothesis validation includes the verification of scientific claims, theorem proving, and experiment validation. Manuscript publication encompasses manuscript writing and the peer review process. Furthermore, we identify and discuss the current challenges faced in these areas, as well as potential future directions for research. Finally, we also offer a comprehensive overview of existing benchmarks and tools across various domains that support the integration of AI into the research process. We hope this paper serves as an introduction for beginners and fosters future research. Resources have been made publicly available at https://github.com/zkzhou126/AI-for-Research.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

The objective of personalized medicine is to tailor interventions to an individual patient's unique characteristics. A key technology for this purpose involves medical digital twins, computational models of human biology that can be personalized and dynamically updated to incorporate patient-specific data collected over time. Certain aspects of human biology, such as the immune system, are not easily captured with physics-based models, such as differential equations. Instead, they are often multi-scale, stochastic, and hybrid. This poses a challenge to existing model-based control and optimization approaches that cannot be readily applied to such models. Recent advances in automatic differentiation and neural-network control methods hold promise in addressing complex control problems. However, the application of these approaches to biomedical systems is still in its early stages. This work introduces dynamics-informed neural-network controllers as an alternative approach to control of medical digital twins. As a first use case for this method, the focus is on agent-based models, a versatile and increasingly common modeling platform in biomedicine. The effectiveness of the proposed neural-network control method is illustrated and benchmarked against other methods with two widely-used agent-based model types. The relevance of the method introduced here extends beyond medical digital twins to other complex dynamical systems.

Diabetes is a chronic disease that poses a significant global health burden, and optimizing diabetes management requires multi-stakeholder collaboration. Large language models (LLMs) have shown promise in various healthcare scenarios, but their effectiveness across a diverse range of diabetes tasks remains unproven. In this study, we introduced a framework to train and validate diabetes-specific LLMs. We first developed a comprehensive data processing pipeline that includes data collection, filtering, augmentation and refinement. This approach contributes to creating a high-quality, diabetes-specific dataset, and several evaluation benchmarks entirely from scratch. Utilizing the collected training dataset, we fine-tuned a diabetes-specific LLM family that demonstrated state-of-the-art proficiency in understanding and processing various diabetes tasks compared to other LLMs. Furthermore, clinical studies showed the potential applications of our models in diabetes care, including providing personalized healthcare, assisting medical education, and streamlining clinical tasks. In conclusion, our study introduced a framework to develop and evaluate a diabetes-specific LLM family, and highlighted its potential to enhance clinical practice and provide personalized, data-driven support for diabetes support when facing different end users. The code is provided via GitHub at https://github.com/waltonfuture/Diabetica.

Recently, test-time scaling has garnered significant attention from the research community, largely due to the substantial advancements of the o1 model released by OpenAI. By allocating more computational resources during the inference phase, large language models~(LLMs) can extensively explore the solution space by generating more thought tokens or diverse solutions, thereby producing more accurate responses. However, developing an o1-like reasoning approach is challenging, and researchers have been making various attempts to advance this open area of research. In this paper, we present a preliminary exploration into enhancing the reasoning abilities of LLMs through reward-guided tree search algorithms. This framework is implemented by integrating the policy model, reward model, and search algorithm. It is primarily constructed around a tree search algorithm, where the policy model navigates a dynamically expanding tree guided by a specially trained reward model. We thoroughly explore various design considerations necessary for implementing this framework and provide a detailed report of the technical aspects. To assess the effectiveness of our approach, we focus on mathematical reasoning tasks and conduct extensive evaluations on four challenging datasets, significantly enhancing the reasoning abilities of LLMs.

Seeking health-related advice on the internet has become a common practice in the digital era. Determining the trustworthiness of medical claims found online and finding appropriate evidence for this information is increasingly challenging. Fact-checking has emerged as an approach to assess the veracity of factual claims using evidence from credible knowledge sources. To help advance the automation of this task, in this paper, we introduce a novel dataset of 750 health-related claims, labeled for veracity by medical experts and backed with evidence from appropriate clinical studies. We provide an analysis of the dataset, highlighting its characteristics and challenges. The dataset can be used for Machine Learning tasks related to automated fact-checking such as evidence retrieval, veracity prediction, and explanation generation. For this purpose, we provide baseline models based on different approaches, examine their performance, and discuss the findings.

Reasoning language models (RLMs), also known as Large Reasoning Models (LRMs), such as OpenAI's o1 and o3, DeepSeek-V3, and Alibaba's QwQ, have redefined AI's problem-solving capabilities by extending large language models (LLMs) with advanced reasoning mechanisms. Yet, their high costs, proprietary nature, and complex architectures - uniquely combining Reinforcement Learning (RL), search heuristics, and LLMs - present accessibility and scalability challenges. To address these, we propose a comprehensive blueprint that organizes RLM components into a modular framework, based on a survey and analysis of all RLM works. This blueprint incorporates diverse reasoning structures (chains, trees, graphs, and nested forms), reasoning strategies (e.g., Monte Carlo Tree Search, Beam Search), RL concepts (policy, value models and others), and supervision schemes (Output-Based and Process-Based Supervision). We also provide detailed mathematical formulations and algorithmic specifications to simplify RLM implementation. By showing how schemes like LLaMA-Berry, QwQ, Journey Learning, and Graph of Thoughts fit as special cases, we demonstrate the blueprint's versatility and unifying potential. To illustrate its utility, we introduce x1, a modular implementation for rapid RLM prototyping and experimentation. Using x1 and a literature review, we provide key insights, such as multi-phase training for policy and value models, and the importance of familiar training distributions. Finally, we outline how RLMs can integrate with a broader LLM ecosystem, including tools and databases. Our work demystifies RLM construction, democratizes advanced reasoning capabilities, and fosters innovation, aiming to mitigate the gap between "rich AI" and "poor AI" by lowering barriers to RLM development and experimentation.

We propose a novel dynamic safety framework that optimizes language model (LM) safety reasoning at inference time without modifying model weights. Building on recent advances in self-critique methods, our approach leverages a meta-critique mechanism that iteratively updates safety prompts-termed specifications-to drive the critique and revision process adaptively. This test-time optimization not only improves performance against adversarial jailbreak requests but also in diverse general safety-related tasks, such as avoiding moral harm or pursuing honest responses. Our empirical evaluations across several language models demonstrate that dynamically optimized safety prompts yield significantly higher safety scores compared to fixed system prompts and static self-critique defenses. Code to be released at https://github.com/vicgalle/meta-self-critique.git .

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios.

In this paper, we address the challenging task of multimodal mathematical reasoning by incorporating the ability of "slow thinking" into multimodal large language models (MLLMs). Our core idea is that different levels of reasoning abilities can be combined dynamically to tackle questions with different complexity. To this end, we propose a paradigm of Self-structured Chain of Thought (SCoT), which is composed of minimal semantic atomic steps. Different from existing methods that rely on structured templates or free-form paradigms, our method can not only generate cognitive CoT structures for various complex tasks but also mitigates the phenomenon of overthinking. To introduce structured reasoning capabilities into visual understanding models, we further design a novel AtomThink framework with four key modules, including (i) a data engine to generate high-quality multimodal reasoning paths; (ii) a supervised fine-tuning process with serialized inference data; (iii) a policy-guided multi-turn inference method; and (iv) an atomic capability metric to evaluate the single step utilization rate. We conduct extensive experiments to show that the proposed AtomThink significantly improves the performance of baseline MLLMs, achieving more than 10\% average accuracy gains on MathVista and MathVerse. Compared to state-of-the-art structured CoT approaches, our method not only achieves higher accuracy but also improves data utilization by 5 times and boosts inference efficiency by 85.3\%. Our code is now public available in https://github.com/Quinn777/AtomThink.

Language has long been conceived as an essential tool for human reasoning. The breakthrough of Large Language Models (LLMs) has sparked significant research interest in leveraging these models to tackle complex reasoning tasks. Researchers have moved beyond simple autoregressive token generation by introducing the concept of "thought" -- a sequence of tokens representing intermediate steps in the reasoning process. This innovative paradigm enables LLMs' to mimic complex human reasoning processes, such as tree search and reflective thinking. Recently, an emerging trend of learning to reason has applied reinforcement learning (RL) to train LLMs to master reasoning processes. This approach enables the automatic generation of high-quality reasoning trajectories through trial-and-error search algorithms, significantly expanding LLMs' reasoning capacity by providing substantially more training data. Furthermore, recent studies demonstrate that encouraging LLMs to "think" with more tokens during test-time inference can further significantly boost reasoning accuracy. Therefore, the train-time and test-time scaling combined to show a new research frontier -- a path toward Large Reasoning Model. The introduction of OpenAI's o1 series marks a significant milestone in this research direction. In this survey, we present a comprehensive review of recent progress in LLM reasoning. We begin by introducing the foundational background of LLMs and then explore the key technical components driving the development of large reasoning models, with a focus on automated data construction, learning-to-reason techniques, and test-time scaling. We also analyze popular open-source projects at building large reasoning models, and conclude with open challenges and future research directions.

Many challenging reasoning tasks require not just rapid, intuitive responses, but a more deliberate, multi-step approach. Recent progress in large language models (LLMs) highlights an important shift from the "System 1" way of quick reactions to the "System 2" style of reflection-and-correction problem solving. However, current benchmarks heavily rely on the final-answer accuracy, leaving much of a model's intermediate reasoning steps unexamined. This fails to assess the model's ability to reflect and rectify mistakes within the reasoning process. To bridge this gap, we introduce FINEREASON, a logic-puzzle benchmark for fine-grained evaluation of LLMs' reasoning capabilities. Each puzzle can be decomposed into atomic steps, making it ideal for rigorous validation of intermediate correctness. Building on this, we introduce two tasks: state checking, and state transition, for a comprehensive evaluation of how models assess the current situation and plan the next move. To support broader research, we also provide a puzzle training set aimed at enhancing performance on general mathematical tasks. We show that models trained on our state checking and transition data demonstrate gains in math reasoning by up to 5.1% on GSM8K.

Remarkable progress has been made on automated reasoning with natural text, by using Language Models (LMs) and methods such as Chain-of-Thought and Selection-Inference. These techniques search for proofs in the forward direction from axioms to the conclusion, which suffers from a combinatorial explosion of the search space, and thus high failure rates for problems requiring longer chains of reasoning. The classical automated reasoning literature has shown that reasoning in the backward direction (i.e. from the intended conclusion to supporting axioms) is significantly more efficient at proof-finding. Importing this intuition into the LM setting, we develop a Backward Chaining algorithm, called LAMBADA, that decomposes reasoning into four sub-modules. These sub-modules are simply implemented by few-shot prompted LM inference. We show that LAMBADA achieves sizable accuracy boosts over state-of-the-art forward reasoning methods on challenging logical reasoning datasets, particularly when deep and accurate proof chains are required.

Understanding how deep learning models predict oncology patient risk can provide critical insights into disease progression, support clinical decision-making, and pave the way for trustworthy and data-driven precision medicine. Building on recent advances in the spatial modeling of the tumor microenvironment using graph neural networks, we present an explainable cell graph (xCG) approach for survival prediction. We validate our model on a public cohort of imaging mass cytometry (IMC) data for 416 cases of lung adenocarcinoma. We explain survival predictions in terms of known phenotypes on the cell level by computing risk attributions over cell graphs, for which we propose an efficient grid-based layer-wise relevance propagation (LRP) method. Our ablation studies highlight the importance of incorporating the cancer stage and model ensembling to improve the quality of risk estimates. Our xCG method, together with the IMC data, is made publicly available to support further research.

The absence of transparency and explainability hinders the clinical adoption of Machine learning (ML) algorithms. Although various methods of explainable artificial intelligence (XAI) have been suggested, there is a lack of literature that delves into their practicality and assesses them based on criteria that could foster trust in clinical environments. To address this gap this study evaluates two popular XAI methods used for explaining predictive models in the healthcare context in terms of whether they (i) generate domain-appropriate representation, i.e. coherent with respect to the application task, (ii) impact clinical workflow and (iii) are consistent. To that end, explanations generated at the cohort and patient levels were analysed. The paper reports the first benchmarking of the XAI methods applied to risk prediction models obtained by evaluating the concordance between generated explanations and the trigger of a future clinical deterioration episode recorded by the data collection system. We carried out an analysis using two Electronic Medical Records (EMR) datasets sourced from Australian major hospitals. The findings underscore the limitations of state-of-the-art XAI methods in the clinical context and their potential benefits. We discuss these limitations and contribute to the theoretical development of trustworthy XAI solutions where clinical decision support guides the choice of intervention by suggesting the pattern or drivers for clinical deterioration in the future.

Reinforcement learning (RL) tasks are typically framed as Markov Decision Processes (MDPs), assuming that decisions are made at fixed time intervals. However, many applications of great importance, including healthcare, do not satisfy this assumption, yet they are commonly modelled as MDPs after an artificial reshaping of the data. In addition, most healthcare (and similar) problems are offline by nature, allowing for only retrospective studies. To address both challenges, we begin by discussing the Semi-MDP (SMDP) framework, which formally handles actions of variable timings. We next present a formal way to apply SMDP modifications to nearly any given value-based offline RL method. We use this theory to introduce three SMDP-based offline RL algorithms, namely, SDQN, SDDQN, and SBCQ. We then experimentally demonstrate that only these SMDP-based algorithms learn the optimal policy in variable-time environments, whereas their MDP counterparts do not. Finally, we apply our new algorithms to a real-world offline dataset pertaining to warfarin dosing for stroke prevention and demonstrate similar results.

Thinking aloud is an effective meta-cognitive strategy human reasoners apply to solve difficult problems. We suggest to improve the reasoning ability of pre-trained neural language models in a similar way, namely by expanding a task's context with problem elaborations that are dynamically generated by the language model itself. Our main result is that dynamic problem elaboration significantly improves the zero-shot performance of GPT-2 in a deductive reasoning and natural language inference task: While the model uses a syntactic heuristic for predicting an answer, it is capable (to some degree) of generating reasoned additional context which facilitates the successful application of its heuristic. We explore different ways of generating elaborations, including fewshot learning, and find that their relative performance varies with the specific problem characteristics (such as problem difficulty). Moreover, the effectiveness of an elaboration can be explained in terms of the degree to which the elaboration semantically coheres with the corresponding problem. In particular, elaborations that are most faithful to the original problem description may boost accuracy by up to 24%.

With the emergence of advanced reasoning models like OpenAI o3 and DeepSeek-R1, large language models (LLMs) have demonstrated remarkable reasoning capabilities. However, their ability to perform rigorous logical reasoning remains an open question. This survey synthesizes recent advancements in logical reasoning within LLMs, a critical area of AI research. It outlines the scope of logical reasoning in LLMs, its theoretical foundations, and the benchmarks used to evaluate reasoning proficiency. We analyze existing capabilities across different reasoning paradigms - deductive, inductive, abductive, and analogical - and assess strategies to enhance reasoning performance, including data-centric tuning, reinforcement learning, decoding strategies, and neuro-symbolic approaches. The review concludes with future directions, emphasizing the need for further exploration to strengthen logical reasoning in AI systems.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

Reasoning is central to a wide range of intellectual activities, and while the capabilities of large language models (LLMs) continue to advance, their performance in reasoning tasks remains limited. The processes and mechanisms underlying reasoning are not yet fully understood, but key elements include path exploration, selection of relevant knowledge, and multi-step inference. Problems are solved through the synthesis of these components. In this paper, we propose a benchmark that focuses on a specific aspect of reasoning ability: the direct evaluation of multi-step inference. To this end, we design a special reasoning task where multi-step inference is specifically focused by largely eliminating path exploration and implicit knowledge utilization. Our dataset comprises pairs of explicit instructions and corresponding questions, where the procedures necessary for solving the questions are entirely detailed within the instructions. This setup allows models to solve problems solely by following the provided directives. By constructing problems that require varying numbers of steps to solve and evaluating responses at each step, we enable a thorough assessment of state-of-the-art LLMs' ability to follow instructions. To ensure the robustness of our evaluation, we include multiple distinct tasks. Furthermore, by comparing accuracy across tasks, utilizing step-aware metrics, and applying separately defined measures of complexity, we conduct experiments that offer insights into the capabilities and limitations of LLMs in reasoning tasks. Our findings have significant implications for the development of LLMs and highlight areas for future research in advancing their reasoning abilities. Our dataset is available at https://huggingface.co/datasets/ifujisawa/procbench and code at https://github.com/ifujisawa/proc-bench.

Large Language Models (LLMs) have shown impressive performance on existing medical question-answering benchmarks. This high performance makes it increasingly difficult to meaningfully evaluate and differentiate advanced methods. We present MedAgentsBench, a benchmark that focuses on challenging medical questions requiring multi-step clinical reasoning, diagnosis formulation, and treatment planning-scenarios where current models still struggle despite their strong performance on standard tests. Drawing from seven established medical datasets, our benchmark addresses three key limitations in existing evaluations: (1) the prevalence of straightforward questions where even base models achieve high performance, (2) inconsistent sampling and evaluation protocols across studies, and (3) lack of systematic analysis of the interplay between performance, cost, and inference time. Through experiments with various base models and reasoning methods, we demonstrate that the latest thinking models, DeepSeek R1 and OpenAI o3, exhibit exceptional performance in complex medical reasoning tasks. Additionally, advanced search-based agent methods offer promising performance-to-cost ratios compared to traditional approaches. Our analysis reveals substantial performance gaps between model families on complex questions and identifies optimal model selections for different computational constraints. Our benchmark and evaluation framework are publicly available at https://github.com/gersteinlab/medagents-benchmark.

The integration of slow-thinking mechanisms into large language models (LLMs) offers a promising way toward achieving Level 2 AGI Reasoners, as exemplified by systems like OpenAI's o1. However, several significant challenges remain, including inefficient overthinking and an overreliance on auxiliary reward models. We point out that these limitations stem from LLMs' inability to internalize the search process, a key component of effective reasoning. A critical step toward addressing this issue is enabling LLMs to autonomously determine when and where to backtrack, a fundamental operation in traditional search algorithms. To this end, we propose a self-backtracking mechanism that equips LLMs with the ability to backtrack during both training and inference. This mechanism not only enhances reasoning ability but also efficiency by transforming slow-thinking processes into fast-thinking through self-improvement. Empirical evaluations demonstrate that our proposal significantly enhances the reasoning capabilities of LLMs, achieving a performance gain of over 40 percent compared to the optimal-path supervised fine-tuning method. We believe this study introduces a novel and promising pathway for developing more advanced and robust Reasoners.

Postprandial hyperglycemia, marked by the blood glucose level exceeding the normal range after meals, is a critical indicator of progression toward type 2 diabetes in prediabetic and healthy individuals. A key metric for understanding blood glucose dynamics after eating is the postprandial area under the curve (PAUC). Predicting PAUC in advance based on a person's diet and activity level and explaining what affects postprandial blood glucose could allow an individual to adjust their lifestyle accordingly to maintain normal glucose levels. In this paper, we propose GlucoLens, an explainable machine learning approach to predict PAUC and hyperglycemia from diet, activity, and recent glucose patterns. We conducted a five-week user study with 10 full-time working individuals to develop and evaluate the computational model. Our machine learning model takes multimodal data including fasting glucose, recent glucose, recent activity, and macronutrient amounts, and provides an interpretable prediction of the postprandial glucose pattern. Our extensive analyses of the collected data revealed that the trained model achieves a normalized root mean squared error (NRMSE) of 0.123. On average, GlucoLense with a Random Forest backbone provides a 16% better result than the baseline models. Additionally, GlucoLens predicts hyperglycemia with an accuracy of 74% and recommends different options to help avoid hyperglycemia through diverse counterfactual explanations. Code available: https://github.com/ab9mamun/GlucoLens.

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/.

Large Language Models (LLMs) have demonstrated significant potential in handling complex reasoning tasks through step-by-step rationale generation. However, recent studies have raised concerns regarding the hallucination and flaws in their reasoning process. Substantial efforts are being made to improve the reliability and faithfulness of the generated rationales. Some approaches model reasoning as planning, while others focus on annotating for process supervision. Nevertheless, the planning-based search process often results in high latency due to the frequent assessment of intermediate reasoning states and the extensive exploration space. Additionally, supervising the reasoning process with human annotation is costly and challenging to scale for LLM training. To address these issues, in this paper, we propose a framework to learn planning-based reasoning through direct preference optimization (DPO) on collected trajectories, which are ranked according to synthesized process rewards. Our results on challenging logical reasoning benchmarks demonstrate the effectiveness of our learning framework, showing that our 7B model can surpass the strong counterparts like GPT-3.5-Turbo.

Large language models (LLMs) have shown increasing capability in problem-solving and decision-making, largely based on the step-by-step chain-of-thought reasoning processes. However, it has been increasingly challenging to evaluate the reasoning capability of LLMs. Concretely, existing outcome-based benchmarks begin to saturate and become less sufficient to monitor the progress. To this end, we present a process-based benchmark MR-BEN that demands a meta reasoning skill, where LMs are asked to locate and analyse potential errors in automatically generated reasoning steps. MR-BEN is a comprehensive benchmark comprising 5,975 questions collected from human experts, covering various subjects such as physics, chemistry, logic, coding, and more. Through our designed metrics for assessing meta-reasoning on this benchmark, we identify interesting limitations and weaknesses of current LLMs (open-source and closed-source models). For example, open-source models are seemingly comparable to GPT-4 on outcome-based benchmarks, but they lag far behind on our benchmark, revealing the underlying reasoning capability gap between them. Our dataset and codes are available on https://randolph-zeng.github.io/Mr-Ben.github.io/.

This paper explores the task of radiology report generation, which aims at generating free-text descriptions for a set of radiographs. One significant challenge of this task is how to correctly maintain the consistency between the images and the lengthy report. Previous research explored solving this issue through planning-based methods, which generate reports only based on high-level plans. However, these plans usually only contain the major observations from the radiographs (e.g., lung opacity), lacking much necessary information, such as the observation characteristics and preliminary clinical diagnoses. To address this problem, the system should also take the image information into account together with the textual plan and perform stronger reasoning during the generation process. In this paper, we propose an observation-guided radiology report generation framework (ORGAN). It first produces an observation plan and then feeds both the plan and radiographs for report generation, where an observation graph and a tree reasoning mechanism are adopted to precisely enrich the plan information by capturing the multi-formats of each observation. Experimental results demonstrate that our framework outperforms previous state-of-the-art methods regarding text quality and clinical efficacy

In this work, we use large language models (LLMs) to augment and accelerate research on the P versus NP problem, one of the most important open problems in theoretical computer science and mathematics. Specifically, we propose Socratic reasoning, a general framework that promotes in-depth thinking with LLMs for complex problem-solving. Socratic reasoning encourages LLMs to recursively discover, solve, and integrate problems while facilitating self-evaluation and refinement. Our pilot study on the P vs. NP problem shows that GPT-4 successfully produces a proof schema and engages in rigorous reasoning throughout 97 dialogue turns, concluding "P neq NP", which is in alignment with (Xu and Zhou, 2023). The investigation uncovers novel insights within the extensive solution space of LLMs, shedding light on LLM for Science.

Reasoning is a fundamental aspect of human intelligence that plays a crucial role in activities such as problem solving, decision making, and critical thinking. In recent years, large language models (LLMs) have made significant progress in natural language processing, and there is observation that these models may exhibit reasoning abilities when they are sufficiently large. However, it is not yet clear to what extent LLMs are capable of reasoning. This paper provides a comprehensive overview of the current state of knowledge on reasoning in LLMs, including techniques for improving and eliciting reasoning in these models, methods and benchmarks for evaluating reasoning abilities, findings and implications of previous research in this field, and suggestions on future directions. Our aim is to provide a detailed and up-to-date review of this topic and stimulate meaningful discussion and future work.

Large Language Models (LLMs) and multi-agent systems have shown impressive capabilities in natural language tasks but face challenges in clinical trial applications, primarily due to limited access to external knowledge. Recognizing the potential of advanced clinical trial tools that aggregate and predict based on the latest medical data, we propose an integrated solution to enhance their accessibility and utility. We introduce Clinical Agent System (ClinicalAgent), a clinical multi-agent system designed for clinical trial tasks, leveraging GPT-4, multi-agent architectures, LEAST-TO-MOST, and ReAct reasoning technology. This integration not only boosts LLM performance in clinical contexts but also introduces novel functionalities. The proposed method achieves competitive predictive performance in clinical trial outcome prediction (0.7908 PR-AUC), obtaining a 0.3326 improvement over the standard prompt Method. Publicly available code can be found at https://anonymous.4open.science/r/ClinicalAgent-6671.

We introduce Diagram of Thought (DoT), a framework that models iterative reasoning in large language models (LLMs) as the construction of a directed acyclic graph (DAG) within a single model. Unlike traditional approaches that represent reasoning as linear chains or trees, DoT organizes propositions, critiques, refinements, and verifications into a cohesive DAG structure, allowing the model to explore complex reasoning pathways while maintaining logical consistency. Each node in the diagram corresponds to a proposition that has been proposed, critiqued, refined, or verified, enabling the LLM to iteratively improve its reasoning through natural language feedback. By leveraging auto-regressive next-token prediction with role-specific tokens, DoT facilitates seamless transitions between proposing ideas and critically evaluating them, providing richer feedback than binary signals. Furthermore, we formalize the DoT framework using Topos Theory, providing a mathematical foundation that ensures logical consistency and soundness in the reasoning process. This approach enhances both the training and inference processes within a single LLM, eliminating the need for multiple models or external control mechanisms. DoT offers a conceptual framework for designing next-generation reasoning-specialized models, emphasizing training efficiency, robust reasoning capabilities, and theoretical grounding. The code is available at https://github.com/diagram-of-thought/diagram-of-thought.

Cognitive dynamics are pivotal to advance human understanding of the world. Recent advancements in large language models (LLMs) reveal their potential for cognitive simulation. However, these LLM-based cognitive studies primarily focus on static modeling, overlooking the dynamic nature of cognition. To bridge this gap, we propose the concept of the cognitive dynamics of LLMs and present a corresponding task with the inspiration of longitudinal studies. Towards the task, we develop CogBench, a novel benchmark to assess the cognitive dynamics of LLMs and validate it through participant surveys. We also design two evaluation metrics for CogBench, including Authenticity and Rationality. Recognizing the inherent static nature of LLMs, we introduce CogGPT for the task, which features an innovative iterative cognitive mechanism aimed at enhancing lifelong cognitive dynamics. Empirical results demonstrate the superiority of CogGPT over existing methods, particularly in its ability to facilitate role-specific cognitive dynamics under continuous information flows.

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

Leveraging recent advancements in large language models, modern neural code completion models have demonstrated the capability to generate highly accurate code suggestions. However, their massive size poses challenges in terms of computational costs and environmental impact, hindering their widespread adoption in practical scenarios. Dynamic inference emerges as a promising solution, as it allocates minimal computation during inference while maintaining the model's performance. In this research, we explore dynamic inference within the context of code completion. Initially, we conducted an empirical investigation on GPT-2, focusing on the inference capabilities of intermediate layers for code completion. We found that 54.4% of tokens can be accurately generated using just the first layer, signifying significant computational savings potential. Moreover, despite using all layers, the model still fails to predict 14.5% of tokens correctly, and the subsequent completions continued from them are rarely considered helpful, with only a 4.2% Acceptance Rate. These findings motivate our exploration of dynamic inference in code completion and inspire us to enhance it with a decision-making mechanism that stops the generation of incorrect code. We thus propose a novel dynamic inference method specifically tailored for code completion models. This method aims not only to produce correct predictions with largely reduced computation but also to prevent incorrect predictions proactively. Our extensive evaluation shows that it can averagely skip 1.7 layers out of 16 layers in the models, leading to an 11.2% speedup with only a marginal 1.1% reduction in ROUGE-L.

As the capabilities of Large Language Models (LLMs) in healthcare and medicine continue to advance, there is a growing need for competitive open-source models that can safeguard public interest. With the increasing availability of highly competitive open base models, the impact of continued pre-training is increasingly uncertain. In this work, we explore the role of instruct tuning, model merging, alignment, red teaming and advanced inference schemes, as means to improve current open models. To that end, we introduce the Aloe family, a set of open medical LLMs highly competitive within its scale range. Aloe models are trained on the current best base models (Mistral, LLaMA 3), using a new custom dataset which combines public data sources improved with synthetic Chain of Thought (CoT). Aloe models undergo an alignment phase, becoming one of the first few policy-aligned open healthcare LLM using Direct Preference Optimization, setting a new standard for ethical performance in healthcare LLMs. Model evaluation expands to include various bias and toxicity datasets, a dedicated red teaming effort, and a much-needed risk assessment for healthcare LLMs. Finally, to explore the limits of current LLMs in inference, we study several advanced prompt engineering strategies to boost performance across benchmarks, yielding state-of-the-art results for open healthcare 7B LLMs, unprecedented at this scale.

Dynamical systems with complex behaviours, e.g. immune system cells interacting with a pathogen, are commonly modelled by splitting the behaviour into different regimes, or modes, each with simpler dynamics, and then learning the switching behaviour from one mode to another. Switching Dynamical Systems (SDS) are a powerful tool that automatically discovers these modes and mode-switching behaviour from time series data. While effective, these methods focus on independent objects, where the modes of one object are independent of the modes of the other objects. In this paper, we focus on the more general interacting object setting for switching dynamical systems, where the per-object dynamics also depends on an unknown and dynamically changing subset of other objects and their modes. To this end, we propose a novel graph-based approach for switching dynamical systems, GRAph Switching dynamical Systems (GRASS), in which we use a dynamic graph to characterize interactions between objects and learn both intra-object and inter-object mode-switching behaviour. We introduce two new datasets for this setting, a synthesized ODE-driven particles dataset and a real-world Salsa Couple Dancing dataset. Experiments show that GRASS can consistently outperforms previous state-of-the-art methods.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

Many real-world systems exhibit temporal, dynamic behaviors, which are captured as time series of complex agent interactions. To perform temporal reasoning, current methods primarily encode temporal dynamics through simple sequence-based models. However, in general these models fail to efficiently capture the full spectrum of rich dynamics in the input, since the dynamics is not uniformly distributed. In particular, relevant information might be harder to extract and computing power is wasted for processing all individual timesteps, even if they contain no significant changes or no new information. Here we propose TimeGraphs, a novel approach that characterizes dynamic interactions as a hierarchical temporal graph, diverging from traditional sequential representations. Our approach models the interactions using a compact graph-based representation, enabling adaptive reasoning across diverse time scales. Adopting a self-supervised method, TimeGraphs constructs a multi-level event hierarchy from a temporal input, which is then used to efficiently reason about the unevenly distributed dynamics. This construction process is scalable and incremental to accommodate streaming data. We evaluate TimeGraphs on multiple datasets with complex, dynamic agent interactions, including a football simulator, the Resistance game, and the MOMA human activity dataset. The results demonstrate both robustness and efficiency of TimeGraphs on a range of temporal reasoning tasks. Our approach obtains state-of-the-art performance and leads to a performance increase of up to 12.2% on event prediction and recognition tasks over current approaches. Our experiments further demonstrate a wide array of capabilities including zero-shot generalization, robustness in case of data sparsity, and adaptability to streaming data flow.

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

Predicting disease trajectories from electronic health records (EHRs) is a complex task due to major challenges such as data non-stationarity, high granularity of medical codes, and integration of multimodal data. EHRs contain both structured data, such as diagnostic codes, and unstructured data, such as clinical notes, which hold essential information often overlooked. Current models, primarily based on structured data, struggle to capture the complete medical context of patients, resulting in a loss of valuable information. To address this issue, we propose an approach that integrates unstructured clinical notes into transformer-based deep learning models for sequential disease prediction. This integration enriches the representation of patients' medical histories, thereby improving the accuracy of diagnosis predictions. Experiments on MIMIC-IV datasets demonstrate that the proposed approach outperforms traditional models relying solely on structured data.

Reasoning is a fundamental capability for solving complex multi-step problems, particularly in visual contexts where sequential step-wise understanding is essential. Existing approaches lack a comprehensive framework for evaluating visual reasoning and do not emphasize step-wise problem-solving. To this end, we propose a comprehensive framework for advancing step-by-step visual reasoning in large language models (LMMs) through three key contributions. First, we introduce a visual reasoning benchmark specifically designed to evaluate multi-step reasoning tasks. The benchmark presents a diverse set of challenges with eight different categories ranging from complex visual perception to scientific reasoning with over 4k reasoning steps in total, enabling robust evaluation of LLMs' abilities to perform accurate and interpretable visual reasoning across multiple steps. Second, we propose a novel metric that assesses visual reasoning quality at the granularity of individual steps, emphasizing both correctness and logical coherence. The proposed metric offers deeper insights into reasoning performance compared to traditional end-task accuracy metrics. Third, we present a new multimodal visual reasoning model, named LlamaV-o1, trained using a multi-step curriculum learning approach, where tasks are progressively organized to facilitate incremental skill acquisition and problem-solving. The proposed LlamaV-o1 is designed for multi-step reasoning and learns step-by-step through a structured training paradigm. Extensive experiments show that our LlamaV-o1 outperforms existing open-source models and performs favorably against close-source proprietary models. Compared to the recent Llava-CoT, our LlamaV-o1 achieves an average score of 67.3 with an absolute gain of 3.8\% across six benchmarks while being 5 times faster during inference scaling. Our benchmark, model, and code are publicly available.

Deductive reasoning plays a pivotal role in the formulation of sound and cohesive arguments. It allows individuals to draw conclusions that logically follow, given the truth value of the information provided. Recent progress in the domain of large language models (LLMs) has showcased their capability in executing deductive reasoning tasks. Nonetheless, a significant portion of research primarily assesses the accuracy of LLMs in solving such tasks, often overlooking a deeper analysis of their reasoning behavior. In this study, we draw upon principles from cognitive psychology to examine inferential strategies employed by LLMs, through a detailed evaluation of their responses to propositional logic problems. Our findings indicate that LLMs display reasoning patterns akin to those observed in humans, including strategies like supposition following or chain construction. Moreover, our research demonstrates that the architecture and scale of the model significantly affect its preferred method of reasoning, with more advanced models tending to adopt strategies more frequently than less sophisticated ones. Importantly, we assert that a model's accuracy, that is the correctness of its final conclusion, does not necessarily reflect the validity of its reasoning process. This distinction underscores the necessity for more nuanced evaluation procedures in the field.

Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.

There is growing excitement about the potential of Language Models (LMs) to accelerate scientific discovery. Falsifying hypotheses is key to scientific progress, as it allows claims to be iteratively refined over time. This process requires significant researcher effort, reasoning, and ingenuity. Yet current benchmarks for LMs predominantly assess their ability to generate solutions rather than challenge them. We advocate for developing benchmarks that evaluate this inverse capability - creating counterexamples for subtly incorrect solutions. To demonstrate this approach, we start with the domain of algorithmic problem solving, where counterexamples can be evaluated automatically using code execution. Specifically, we introduce REFUTE, a dynamically updating benchmark that includes recent problems and incorrect submissions from programming competitions, where human experts successfully identified counterexamples. Our analysis finds that the best reasoning agents, even OpenAI o3-mini (high) with code execution feedback, can create counterexamples for only <9% of incorrect solutions in REFUTE, even though ratings indicate its ability to solve up to 48% of these problems from scratch. We hope our work spurs progress in evaluating and enhancing LMs' ability to falsify incorrect solutions - a capability that is crucial for both accelerating research and making models self-improve through reliable reflective reasoning.

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.

A prominent challenge of offline reinforcement learning (RL) is the issue of hidden confounding: unobserved variables may influence both the actions taken by the agent and the observed outcomes. Hidden confounding can compromise the validity of any causal conclusion drawn from data and presents a major obstacle to effective offline RL. In the present paper, we tackle the problem of hidden confounding in the nonidentifiable setting. We propose a definition of uncertainty due to hidden confounding bias, termed delphic uncertainty, which uses variation over world models compatible with the observations, and differentiate it from the well-known epistemic and aleatoric uncertainties. We derive a practical method for estimating the three types of uncertainties, and construct a pessimistic offline RL algorithm to account for them. Our method does not assume identifiability of the unobserved confounders, and attempts to reduce the amount of confounding bias. We demonstrate through extensive experiments and ablations the efficacy of our approach on a sepsis management benchmark, as well as on electronic health records. Our results suggest that nonidentifiable hidden confounding bias can be mitigated to improve offline RL solutions in practice.

Learning accurate predictive models of real-world dynamic phenomena (e.g., climate, biological) remains a challenging task. One key issue is that the data generated by both natural and artificial processes often comprise time series that are irregularly sampled and/or contain missing observations. In this work, we propose the Neural Continuous-Discrete State Space Model (NCDSSM) for continuous-time modeling of time series through discrete-time observations. NCDSSM employs auxiliary variables to disentangle recognition from dynamics, thus requiring amortized inference only for the auxiliary variables. Leveraging techniques from continuous-discrete filtering theory, we demonstrate how to perform accurate Bayesian inference for the dynamic states. We propose three flexible parameterizations of the latent dynamics and an efficient training objective that marginalizes the dynamic states during inference. Empirical results on multiple benchmark datasets across various domains show improved imputation and forecasting performance of NCDSSM over existing models.

The rapid advancements in Vision-Language Models (VLMs) have shown great potential in tackling mathematical reasoning tasks that involve visual context. Unlike humans who can reliably apply solution steps to similar problems with minor modifications, we found that SOTA VLMs like GPT-4o can consistently fail in these scenarios, revealing limitations in their mathematical reasoning capabilities. In this paper, we investigate the mathematical reasoning robustness in VLMs and evaluate how well these models perform under different variants of the same question, such as changes in visual numerical values or function graphs. While several vision-based math benchmarks have been developed to assess VLMs' problem-solving capabilities, these benchmarks contain only static sets of problems and cannot easily evaluate mathematical reasoning robustness. To fill this gap, we introduce DynaMath, a dynamic visual math benchmark designed for in-depth assessment of VLMs. DynaMath includes 501 high-quality, multi-topic seed questions, each represented as a Python program. Those programs are carefully designed and annotated to enable the automatic generation of a much larger set of concrete questions, including many different types of visual and textual variations. DynaMath allows us to evaluate the generalization ability of VLMs, by assessing their performance under varying input conditions of a seed question. We evaluated 14 SOTA VLMs with 5,010 generated concrete questions. Our results show that the worst-case model accuracy, defined as the percentage of correctly answered seed questions in all 10 variants, is significantly lower than the average-case accuracy. Our analysis emphasizes the need to study the robustness of VLMs' reasoning abilities, and DynaMath provides valuable insights to guide the development of more reliable models for mathematical reasoning.

As practitioners increasingly deploy machine learning models in critical domains such as health care, finance, and policy, it becomes vital to ensure that domain experts function effectively alongside these models. Explainability is one way to bridge the gap between human decision-makers and machine learning models. However, most of the existing work on explainability focuses on one-off, static explanations like feature importances or rule lists. These sorts of explanations may not be sufficient for many use cases that require dynamic, continuous discovery from stakeholders. In the literature, few works ask decision-makers about the utility of existing explanations and other desiderata they would like to see in an explanation going forward. In this work, we address this gap and carry out a study where we interview doctors, healthcare professionals, and policymakers about their needs and desires for explanations. Our study indicates that decision-makers would strongly prefer interactive explanations in the form of natural language dialogues. Domain experts wish to treat machine learning models as "another colleague", i.e., one who can be held accountable by asking why they made a particular decision through expressive and accessible natural language interactions. Considering these needs, we outline a set of five principles researchers should follow when designing interactive explanations as a starting place for future work. Further, we show why natural language dialogues satisfy these principles and are a desirable way to build interactive explanations. Next, we provide a design of a dialogue system for explainability and discuss the risks, trade-offs, and research opportunities of building these systems. Overall, we hope our work serves as a starting place for researchers and engineers to design interactive explainability systems.

Treatment effect estimation in continuous time is crucial for personalized medicine. However, existing methods for this task are limited to point estimates of the potential outcomes, whereas uncertainty estimates have been ignored. Needless to say, uncertainty quantification is crucial for reliable decision-making in medical applications. To fill this gap, we propose a novel Bayesian neural controlled differential equation (BNCDE) for treatment effect estimation in continuous time. In our BNCDE, the time dimension is modeled through a coupled system of neural controlled differential equations and neural stochastic differential equations, where the neural stochastic differential equations allow for tractable variational Bayesian inference. Thereby, for an assigned sequence of treatments, our BNCDE provides meaningful posterior predictive distributions of the potential outcomes. To the best of our knowledge, ours is the first tailored neural method to provide uncertainty estimates of treatment effects in continuous time. As such, our method is of direct practical value for promoting reliable decision-making in medicine.

Humans have a powerful and mysterious capacity to reason. By working through a series of purely mental steps, we can make inferences we would not be capable of making directly -- despite the fact that we get no additional data from the world. Similarly, when large language models generate a series of intermediate steps (a chain of thought) before answering a question, they often produce better answers than they otherwise would. We investigate why and how chain-of-thought reasoning is useful in language models, testing the hypothesis that reasoning is effective when training data consists of local clusters of variables that influence each other strongly. These training conditions enable the chaining of accurate local inferences in order to estimate relationships between variables that were not seen together in training. We prove that there will exist a "reasoning gap", where reasoning through intermediate variables improves inference, for the simple case of an autoregressive density estimator trained on local samples from a chain-structured probabilistic model. We then test our hypothesis empirically in more complex models, training an autoregressive language model on samples from Bayes nets but only including a subset of variables in each sample. We test language models' ability to match conditional probabilities with and without intermediate reasoning steps, finding that intermediate steps are only helpful when the training data is locally structured with respect to dependencies between variables and that the combination of locally-structured observations and reasoning is much more data-efficient than training on all variables. Our results illustrate how the effectiveness of reasoning step by step is rooted in the local statistical structure of the training data.

Scaling model size and training data has led to great advances in the performance of Large Language Models (LLMs). However, the diminishing returns of this approach necessitate alternative methods to improve model capabilities, particularly in tasks requiring advanced reasoning. Large reasoning models, which leverage long chain-of-thoughts, bring unprecedented breakthroughs in problem-solving capabilities but at a substantial deployment cost associated to longer generations. Reducing inference costs is crucial for the economic feasibility, user experience, and environmental sustainability of these models. In this work, we propose to train large reasoning models to reason efficiently. More precisely, we use reinforcement learning (RL) to train reasoning models to dynamically allocate inference-time compute based on task complexity. Our method incentivizes models to minimize unnecessary computational overhead while maintaining accuracy, thereby achieving substantial efficiency gains. It enables the derivation of a family of reasoning models with varying efficiency levels, controlled via a single hyperparameter. Experiments on two open-weight large reasoning models demonstrate significant reductions in inference cost while preserving most of the accuracy.

Hallucinations (i.e., generating plausible but inaccurate content) and laziness (i.e. excessive refusals or defaulting to "I don't know") persist as major challenges in LLM reasoning. Current efforts to reduce hallucinations primarily focus on factual errors in knowledge-grounded tasks, often neglecting hallucinations related to faulty reasoning. Meanwhile, some approaches render LLMs overly conservative, limiting their problem-solving capabilities. To mitigate hallucination and laziness in reasoning tasks, we propose Automatic Curriculum Expert Iteration (Auto-CEI) to enhance LLM reasoning and align responses to the model's capabilities--assertively answering within its limits and declining when tasks exceed them. In our method, Expert Iteration explores the reasoning trajectories near the LLM policy, guiding incorrect paths back on track to reduce compounding errors and improve robustness; it also promotes appropriate "I don't know" responses after sufficient reasoning attempts. The curriculum automatically adjusts rewards, incentivizing extended reasoning before acknowledging incapability, thereby pushing the limits of LLM reasoning and aligning its behaviour with these limits. We compare Auto-CEI with various SOTA baselines across logical reasoning, mathematics, and planning tasks, where Auto-CEI achieves superior alignment by effectively balancing assertiveness and conservativeness.

Equipping agents with the capacity to justify made decisions using supporting evidence represents a cornerstone of accountable decision-making. Furthermore, ensuring that justifications are in line with human expectations and societal norms is vital, especially in high-stakes situations such as healthcare. In this work, we propose the use of a debate-based reward model for reinforcement learning agents, where the outcome of a zero-sum debate game quantifies the justifiability of a decision in a particular state. This reward model is then used to train a justifiable policy, whose decisions can be more easily corroborated with supporting evidence. In the debate game, two argumentative agents take turns providing supporting evidence for two competing decisions. Given the proposed evidence, a proxy of a human judge evaluates which decision is better justified. We demonstrate the potential of our approach in learning policies for prescribing and justifying treatment decisions of septic patients. We show that augmenting the reward with the feedback signal generated by the debate-based reward model yields policies highly favored by the judge when compared to the policy obtained solely from the environment rewards, while hardly sacrificing any performance. Moreover, in terms of the overall performance and justifiability of trained policies, the debate-based feedback is comparable to the feedback obtained from an ideal judge proxy that evaluates decisions using the full information encoded in the state. This suggests that the debate game outputs key information contained in states that is most relevant for evaluating decisions, which in turn substantiates the practicality of combining our approach with human-in-the-loop evaluations. Lastly, we showcase that agents trained via multi-agent debate learn to propose evidence that is resilient to refutations and closely aligns with human preferences.

Large language models (LLMs) demonstrate impressive reasoning abilities, but translating reasoning into actions in the real world remains challenging. In particular, it remains unclear how to complete a given task provably within a minimum number of interactions with the external environment, e.g., through an internal mechanism of reasoning. To this end, we propose a principled framework with provable regret guarantees to orchestrate reasoning and acting, which we call "reason for future, act for now" (RAFA). Specifically, we design a prompt template for reasoning that learns from the memory buffer and plans a future trajectory over a long horizon ("reason for future"). At each step, the LLM agent takes the initial action of the planned trajectory ("act for now"), stores the collected feedback in the memory buffer, and reinvokes the reasoning routine to replan the future trajectory from the new state. The key idea is to cast reasoning in LLMs as learning and planning in Bayesian adaptive Markov decision processes (MDPs). Correspondingly, we prompt LLMs to form an updated posterior of the unknown environment from the memory buffer (learning) and generate an optimal trajectory for multiple future steps that maximizes a value function (planning). The learning and planning subroutines are performed in an "in-context" manner to emulate the actor-critic update for MDPs. Our theoretical analysis proves that the novel combination of long-term reasoning and short-term acting achieves a T regret. In particular, the regret bound highlights an intriguing interplay between the prior knowledge obtained through pretraining and the uncertainty reduction achieved by reasoning and acting. Our empirical validation shows that it outperforms various existing frameworks and achieves nearly perfect scores on a few benchmarks.

Traditional Chinese medicine (TCM) plays a vital role in health protection and disease treatment, but its practical application requires extensive medical knowledge and clinical experience. Existing TCM Large Language Models (LLMs) exhibit critical limitations of uncomprehensive medical consultation and diagnoses, and inaccurate syndrome differentiation-based treatment. To address these issues, this study establishes JingFang (JF): a novel TCM Large Language Model that demonstrates the expert-level capability of medical diagnosis and syndrome differentiation-based treatment. We innovate a Multi-agent Dynamic Collaborative Chain-of-Thought Mechanism (MDCCTM) for medical consultation, enabling JF with effective and accurate diagnostic ability. In addition, a Syndrome Agent and a Dual-Stage Retrieval Scheme (DSRS) are developed to significantly enhance the capacity of JF for disease treatment based on syndrome differentiation. JingFang not only facilitates the application of LLMs but also promotes the effective practice of TCM in human health protection and disease treatment.

In many machine learning for healthcare tasks, standard datasets are constructed by amassing data across many, often fundamentally dissimilar, sources. But when does adding more data help, and when does it hinder progress on desired model outcomes in real-world settings? We identify this situation as the Data Addition Dilemma, demonstrating that adding training data in this multi-source scaling context can at times result in reduced overall accuracy, uncertain fairness outcomes, and reduced worst-subgroup performance. We find that this possibly arises from an empirically observed trade-off between model performance improvements due to data scaling and model deterioration from distribution shift. We thus establish baseline strategies for navigating this dilemma, introducing distribution shift heuristics to guide decision-making on which data sources to add in data scaling, in order to yield the expected model performance improvements. We conclude with a discussion of the required considerations for data collection and suggestions for studying data composition and scale in the age of increasingly larger models.

Seismic advances in generative AI algorithms for imagery, text, and other data types has led to the temptation to use synthetic data to train next-generation models. Repeating this process creates an autophagous (self-consuming) loop whose properties are poorly understood. We conduct a thorough analytical and empirical analysis using state-of-the-art generative image models of three families of autophagous loops that differ in how fixed or fresh real training data is available through the generations of training and in whether the samples from previous generation models have been biased to trade off data quality versus diversity. Our primary conclusion across all scenarios is that without enough fresh real data in each generation of an autophagous loop, future generative models are doomed to have their quality (precision) or diversity (recall) progressively decrease. We term this condition Model Autophagy Disorder (MAD), making analogy to mad cow disease.

Exploiting large language models (LLMs) to tackle deductive reasoning has garnered growing attention. It still remains highly challenging to achieve satisfactory results in complex deductive problems, characterized by plenty of premises (i.e., facts or rules) entailing intricate relationships among entities and requiring multi-hop reasoning. One intuitive solution is to decompose the original task into smaller sub-tasks, and then chain the multiple casual reasoning steps together in a forward (e.g., Selection-Inference) or backward (e.g., LAMBADA) direction. However, these techniques inevitably necessitate a large number of overall stages, leading to computationally expensive operations and a higher possibility of making misleading steps. In addition to stage-by-stage decomposition, we draw inspiration from another aspect of human problem-solving. Humans tend to distill the most relevant information and organize their thoughts systematically (e.g., creating mind maps), which assists them in answering questions or drawing conclusions precisely and quickly. In light of this, we propose a novel reasoning approach named Concise and Organized Perception (COP). COP carefully analyzes the given statements to efficiently identify the most pertinent information while eliminating redundancy. It then prompts the LLMs in a more organized form that adapts to the model's inference process. By perceiving concise and organized proofs, the deductive reasoning abilities of LLMs can be better elicited, and the risk of acquiring errors caused by excessive reasoning stages is mitigated. Furthermore, our approach can be combined with the aforementioned ones to further boost their performance. Extensive experimental results on three popular deductive benchmarks (i.e., ProofWriter, PrOntoQA and PrOntoQA-OOD) show that COP significantly outperforms previous state-of-the-art methods.

Large language models (LLMs) have been routinely used to solve various tasks using step-by-step reasoning. However, the structure of intermediate reasoning steps, or thoughts, is rigid and unidirectional, such as chains, trees, or acyclic-directed graphs. Consequently, the resulting inflexible and forward-only reasoning may not address challenging tasks and fail when the LLM frequently gives false responses, i.e., ``hallucinations''. This paper proposes a new reasoning framework, called Thought Rollback (TR), allowing LLMs to adaptively build thought structure while maintaining effective reasoning toward problem-solving under ``hallucinations''. The core mechanism of TR is rolling back thoughts, which allows LLMs to perform error analysis on thoughts, and thus roll back to any previously mistaken thought for revision. Subsequently, by including such trial-and-error in the prompt to guide the LLM, each rollback leads to one more reliable reasoning path. Therefore, starting with a simple prompt without human annotations, LLM with TR adaptively and gradually explores thoughts for a correct solution. Comprehensive experiments on mathematical problems and multi-task reasoning demonstrate the state-of-the-art performance of TR in terms of problem-solving rate and interaction cost. For instance, the solving rate of GPT-4 with TR outperforms the current best by 9% on the MATH dataset.

Advanced models such as OpenAI o1 exhibit impressive problem-solving capabilities through step-by-step reasoning. However, they may still falter on more complex problems, making errors that disrupt their reasoning paths. We attribute this to the expansive solution space, where each step has the risk of diverging into mistakes. To enhance language model reasoning, we introduce a specialized training framework called Reasoning Paths Optimization (RPO), which enables learning to reason and explore from diverse paths. Our approach encourages favorable branches at each reasoning step while penalizing unfavorable ones, enhancing the model's overall problem-solving performance. Reasoning Paths Optimization does not rely on large-scale human-annotated rationales or outputs from closed-source models, making it scalable and data-efficient. We focus on multi-step reasoning tasks, such as math word problems and science-based exam questions. The experiments demonstrate that our framework significantly enhances the reasoning performance of large language models, with up to 3.1% and 4.3% improvement on GSM8K and MMLU (STEM) respectively. Our data and code can be found at https://reasoning-paths.github.io.

The utilization of large language models (LLMs) in the Healthcare domain has generated both excitement and concern due to their ability to effectively respond to freetext queries with certain professional knowledge. This survey outlines the capabilities of the currently developed LLMs for Healthcare and explicates their development process, with the aim of providing an overview of the development roadmap from traditional Pretrained Language Models (PLMs) to LLMs. Specifically, we first explore the potential of LLMs to enhance the efficiency and effectiveness of various Healthcare applications highlighting both the strengths and limitations. Secondly, we conduct a comparison between the previous PLMs and the latest LLMs, as well as comparing various LLMs with each other. Then we summarize related Healthcare training data, training methods, optimization strategies, and usage. Finally, the unique concerns associated with deploying LLMs in Healthcare settings are investigated, particularly regarding fairness, accountability, transparency and ethics. Our survey provide a comprehensive investigation from perspectives of both computer science and Healthcare specialty. Besides the discussion about Healthcare concerns, we supports the computer science community by compiling a collection of open source resources, such as accessible datasets, the latest methodologies, code implementations, and evaluation benchmarks in the Github. Summarily, we contend that a significant paradigm shift is underway, transitioning from PLMs to LLMs. This shift encompasses a move from discriminative AI approaches to generative AI approaches, as well as a shift from model-centered methodologies to datacentered methodologies.

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

Agent Based Models (ABMs) have emerged as a powerful tool for investigating complex social interactions, particularly in the context of public health and infectious disease investigation. In an effort to enhance the conventional ABM, enabling automated model calibration and reducing the computational resources needed for scaling up the model, we have developed a tensorized and differentiable agent-based model by coupling Graph Neural Network (GNN) and Long Short-Term Memory (LSTM) network. The model was employed to investigate the 2019 measles outbreak occurred in New Zealand, demonstrating a promising ability to accurately simulate the outbreak dynamics, particularly during the peak period of repeated cases. This paper shows that by leveraging the latest Artificial Intelligence (AI) technology and the capabilities of traditional ABMs, we gain deeper insights into the dynamics of infectious disease outbreaks. This, in turn, helps us make more informed decision when developing effective strategies that strike a balance between managing outbreaks and minimizing disruptions to everyday life.

Reasoning ability is essential for Large Multimodal Models (LMMs). In the absence of multimodal chain-of-thought annotated data, self-evolving training, where the model learns from its own outputs, has emerged as an effective and scalable approach for enhancing reasoning abilities. Despite its growing usage, a comprehensive understanding of self-evolving training, particularly in the context of multimodal reasoning, remains limited. In this paper, we delve into the intricacies of self-evolving training for multimodal reasoning, pinpointing three key factors: Training Method, Reward Model, and Prompt Variation. We systematically examine each factor and explore how various configurations affect the training's effectiveness. Our analysis leads to a set of best practices for each factor, aimed at optimizing multimodal reasoning. Furthermore, we explore the Self-Evolution Dynamics during training and the impact of automatic balancing mechanisms in boosting performance. After all the investigations, we present a final recipe for self-evolving training in multimodal reasoning, encapsulating these design choices into a framework we call MSTaR (Multimodal Self-evolving Training for Reasoning), which is universally effective for models with different sizes on various benchmarks, e.g., surpassing the pre-evolved model significantly on 5 multimodal reasoning benchmarks without using additional human annotations, as demonstrated on MiniCPM-V-2.5 (8B), Phi-3.5-Vision (4B) and InternVL2 (2B). We believe this study fills a significant gap in the understanding of self-evolving training for multimodal reasoning and offers a robust framework for future research. Our policy and reward models, as well as the collected data, is released to facilitate further investigation in multimodal reasoning.

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

Test-time inference has emerged as a powerful paradigm for enabling language models to ``think'' longer and more carefully about complex challenges, much like skilled human experts. While reinforcement learning (RL) can drive self-improvement in language models on verifiable tasks, some models exhibit substantial gains while others quickly plateau. For instance, we find that Qwen-2.5-3B far exceeds Llama-3.2-3B under identical RL training for the game of Countdown. This discrepancy raises a critical question: what intrinsic properties enable effective self-improvement? We introduce a framework to investigate this question by analyzing four key cognitive behaviors -- verification, backtracking, subgoal setting, and backward chaining -- that both expert human problem solvers and successful language models employ. Our study reveals that Qwen naturally exhibits these reasoning behaviors, whereas Llama initially lacks them. In systematic experimentation with controlled behavioral datasets, we find that priming Llama with examples containing these reasoning behaviors enables substantial improvements during RL, matching or exceeding Qwen's performance. Importantly, the presence of reasoning behaviors, rather than correctness of answers, proves to be the critical factor -- models primed with incorrect solutions containing proper reasoning patterns achieve comparable performance to those trained on correct solutions. Finally, leveraging continued pretraining with OpenWebMath data, filtered to amplify reasoning behaviors, enables the Llama model to match Qwen's self-improvement trajectory. Our findings establish a fundamental relationship between initial reasoning behaviors and the capacity for improvement, explaining why some language models effectively utilize additional computation while others plateau.

We introduce a unified framework for iterative reasoning that leverages non-Euclidean geometry via Bregman divergences, higher-order operator averaging, and adaptive feedback mechanisms. Our analysis establishes that, under mild smoothness and contractivity assumptions, a generalized update scheme not only unifies classical methods such as mirror descent and dynamic programming but also captures modern chain-of-thought reasoning processes in large language models. In particular, we prove that our accelerated iterative update achieves an O(1/t^2) convergence rate in the absence of persistent perturbations, and we further demonstrate that feedback (iterative) architectures are necessary to approximate certain fixed-point functions efficiently. These theoretical insights bridge classical acceleration techniques with contemporary applications in neural computation and optimization.

We present that hierarchical LLM reasoning via scaling thought templates can effectively optimize the reasoning search space and outperform the mathematical reasoning capabilities of powerful LLMs like OpenAI o1-preview and DeepSeek V3. We train our ReasonFlux-32B model with only 8 GPUs and introduces three innovations: (i) a structured and generic thought template library, containing around 500 high-level thought templates capable of generalizing to similar or relevant reasoning problems; (ii) performing hierarchical reinforcement learning on a sequence of thought templates instead of long CoTs, optimizing a base LLM to plan out an optimal template trajectory for gradually handling complex problems; (iii) a brand new inference scaling system that enables hierarchical LLM reasoning by adaptively scaling thought templates at inference time. With a template trajectory containing sequential thought templates, our ReasonFlux-32B significantly advances math reasoning capabilities to state-of-the-art levels. Notably, on the MATH benchmark, it achieves an accuracy of 91.2% and surpasses o1-preview by 6.7%. On the USA Math Olympiad (AIME) benchmark, ReasonFlux-32B solves an average of 56.7% of problems, surpassing o1-preview and DeepSeek-V3 by 27% and 45%, respectively. Code: https://github.com/Gen-Verse/ReasonFlux

Recently, slow-thinking reasoning systems, built upon large language models (LLMs), have garnered widespread attention by scaling the thinking time during inference. There is also growing interest in adapting this capability to multimodal large language models (MLLMs). Given that MLLMs handle more complex data semantics across different modalities, it is intuitively more challenging to implement multimodal slow-thinking systems. To address this issue, in this paper, we explore a straightforward approach by fine-tuning a capable MLLM with a small amount of textual long-form thought data, resulting in a multimodal slow-thinking system, Virgo (Visual reasoning with long thought). We find that these long-form reasoning processes, expressed in natural language, can be effectively transferred to MLLMs. Moreover, it seems that such textual reasoning data can be even more effective than visual reasoning data in eliciting the slow-thinking capacities of MLLMs. While this work is preliminary, it demonstrates that slow-thinking capacities are fundamentally associated with the language model component, which can be transferred across modalities or domains. This finding can be leveraged to guide the development of more powerful slow-thinking reasoning systems. We release our resources at https://github.com/RUCAIBox/Virgo.

Studies have underscored how, regardless of the recent breakthrough and swift advances in AI research, even state-of-the-art Large Language models (LLMs) continue to struggle when performing logical and mathematical reasoning. The results seem to suggest that LLMs still work as (highly advanced) data pattern identifiers, scoring poorly when attempting to generalise and solve reasoning problems the models have never previously seen or that are not close to samples presented in their training data. To address this compelling concern, this paper makes use of the notion of critical questions from the literature on argumentation theory, focusing in particular on Toulmin's model of argumentation. We show that employing these critical questions can improve the reasoning capabilities of LLMs. By probing the rationale behind the models' reasoning process, the LLM can assess whether some logical mistake is occurring and correct it before providing the final reply to the user prompt. The underlying idea is drawn from the gold standard of any valid argumentative procedure: the conclusion is valid if it is entailed by accepted premises. Or, to paraphrase such Aristotelian principle in a real-world approximation, characterised by incomplete information and presumptive logic, the conclusion is valid if not proved otherwise. This approach successfully steers the models' output through a reasoning pipeline, resulting in better performance against the baseline and its Chain-of-Thought (CoT) implementation. To this end, an extensive evaluation of the proposed approach on the MT-Bench Reasoning and Math tasks across a range of LLMs is provided.

Softmax attention is the principle backbone of foundation models for various artificial intelligence applications, yet its quadratic complexity in sequence length can limit its inference throughput in long-context settings. To address this challenge, alternative architectures such as linear attention, State Space Models (SSMs), and Recurrent Neural Networks (RNNs) have been considered as more efficient alternatives. While connections between these approaches exist, such models are commonly developed in isolation and there is a lack of theoretical understanding of the shared principles underpinning these architectures and their subtle differences, greatly influencing performance and scalability. In this paper, we introduce the Dynamical Systems Framework (DSF), which allows a principled investigation of all these architectures in a common representation. Our framework facilitates rigorous comparisons, providing new insights on the distinctive characteristics of each model class. For instance, we compare linear attention and selective SSMs, detailing their differences and conditions under which both are equivalent. We also provide principled comparisons between softmax attention and other model classes, discussing the theoretical conditions under which softmax attention can be approximated. Additionally, we substantiate these new insights with empirical validations and mathematical arguments. This shows the DSF's potential to guide the systematic development of future more efficient and scalable foundation models.

Pre-trained language models (PLMs) have shown impressive performance in various language tasks. However, they are prone to spurious correlations, and often generate illusory information. In real-world applications, PLMs should justify decisions with formalized, coherent reasoning chains, but this challenge remains under-explored. Cognitive psychology theorizes that humans are capable of utilizing fast and intuitive heuristic thinking to make decisions based on past experience, then rationalizing the decisions through slower and deliberative analytic reasoning. We incorporate these interlinked dual processes in fine-tuning and in-context learning with PLMs, applying them to two language understanding tasks that require coherent physical commonsense reasoning. We show that our proposed Heuristic-Analytic Reasoning (HAR) strategies drastically improve the coherence of rationalizations for model decisions, yielding state-of-the-art results on Tiered Reasoning for Intuitive Physics (TRIP). We also find that this improved coherence is a direct result of more faithful attention to relevant language context in each step of reasoning. Our findings suggest that human-like reasoning strategies can effectively improve the coherence and reliability of PLM reasoning.

This paper presents a novel framework for enhancing reasoning capabilities in large language models (LLMs) by leveraging iterative reasoning and feedback-driven methodologies. Building on the limitations identified in the SimpleBench benchmark, a dataset designed to evaluate logical coherence and real-world reasoning, we propose a multi-step prompting strategy coupled with global consistency checks to improve model accuracy and robustness. Through comparative analysis of state-of-the-art models, including Claude 3 Opus, Claude 3.5, GPT- 4o, and o1-preview, we demonstrate that iterative reasoning significantly enhances model performance, with improvements observed in both standard accuracy metrics (AVG@5) and a newly introduced metric, Extreme Averaging (EAG@5). Our results reveal model-specific strengths: Claude excels in maintaining logical consistency, while GPT-4o exhibits exploratory creativity but struggles with ambiguous prompts. By analyzing case studies and identifying gaps in spatial and temporal reasoning, we highlight areas for further refinement. The findings underscore the potential of structured reasoning frameworks to address inherent model limitations, irrespective of pretraining methodologies. This study lays the groundwork for integrating dynamic feedback mechanisms, adaptive restart strategies, and diverse evaluation metrics to advance LLM reasoning capabilities across complex and multi-domain problem spaces.

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

The Retrieval-Augmented Language Model (RALM) has shown remarkable performance on knowledge-intensive tasks by incorporating external knowledge during inference, which mitigates the factual hallucinations inherited in large language models (LLMs). Despite these advancements, challenges persist in the implementation of RALMs, particularly concerning their reliability and traceability. To be specific, the irrelevant document retrieval may result in unhelpful response generation or even deteriorate the performance of LLMs, while the lack of proper citations in generated outputs complicates efforts to verify the trustworthiness of the models. To this end, we propose a novel self-reasoning framework aimed at improving the reliability and traceability of RALMs, whose core idea is to leverage reasoning trajectories generated by the LLM itself. The framework involves constructing self-reason trajectories with three processes: a relevance-aware process, an evidence-aware selective process, and a trajectory analysis process. We have evaluated our framework across four public datasets (two short-form QA datasets, one long-form QA dataset, and one fact verification dataset) to demonstrate the superiority of our method, which can outperform existing state-of-art models and can achieve comparable performance with GPT-4, while only using 2,000 training samples.

Large Language Models (LLMs) have made notable progress in mathematical reasoning, yet they often rely on single-paradigm reasoning that limits their effectiveness across diverse tasks. In this paper, we introduce Chain-of-Reasoning (CoR), a novel unified framework that integrates multiple reasoning paradigms--Natural Language Reasoning (NLR), Algorithmic Reasoning (AR), and Symbolic Reasoning (SR)--to enable synergistic collaboration. CoR generates multiple potential answers using different reasoning paradigms and synthesizes them into a coherent final solution. We propose a Progressive Paradigm Training (PPT) strategy that allows models to progressively master these paradigms, culminating in the development of CoR-Math-7B. Experimental results demonstrate that CoR-Math-7B significantly outperforms current SOTA models, achieving up to a 41.0% absolute improvement over GPT-4 in theorem proving tasks and a 7.9% improvement over RL-based methods in arithmetic tasks. These results showcase the enhanced mathematical comprehensive ability of our model, achieving significant performance gains on specific tasks and enabling zero-shot generalization across tasks.

Recent advancements in Chain-of-Thought prompting have facilitated significant breakthroughs for Large Language Models (LLMs) in complex reasoning tasks. Current research enhances the reasoning performance of LLMs by sampling multiple reasoning chains and ensembling based on the answer frequency. However, this approach fails in scenarios where the correct answers are in the minority. We identify this as a primary factor constraining the reasoning capabilities of LLMs, a limitation that cannot be resolved solely based on the predicted answers. To address this shortcoming, we introduce a hierarchical reasoning aggregation framework AoR (Aggregation of Reasoning), which selects answers based on the evaluation of reasoning chains. Additionally, AoR incorporates dynamic sampling, adjusting the number of reasoning chains in accordance with the complexity of the task. Experimental results on a series of complex reasoning tasks show that AoR outperforms prominent ensemble methods. Further analysis reveals that AoR not only adapts various LLMs but also achieves a superior performance ceiling when compared to current methods.

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

We propose a new class of deep reinforcement learning (RL) algorithms that model latent representations in hyperbolic space. Sequential decision-making requires reasoning about the possible future consequences of current behavior. Consequently, capturing the relationship between key evolving features for a given task is conducive to recovering effective policies. To this end, hyperbolic geometry provides deep RL models with a natural basis to precisely encode this inherently hierarchical information. However, applying existing methodologies from the hyperbolic deep learning literature leads to fatal optimization instabilities due to the non-stationarity and variance characterizing RL gradient estimators. Hence, we design a new general method that counteracts such optimization challenges and enables stable end-to-end learning with deep hyperbolic representations. We empirically validate our framework by applying it to popular on-policy and off-policy RL algorithms on the Procgen and Atari 100K benchmarks, attaining near universal performance and generalization benefits. Given its natural fit, we hope future RL research will consider hyperbolic representations as a standard tool.

PRefLexOR (Preference-based Recursive Language Modeling for Exploratory Optimization of Reasoning) combines preference optimization with concepts from Reinforcement Learning to enable models to self-teach through iterative reasoning improvements. We propose a recursive learning approach that engages the model in multi-step reasoning, revisiting, and refining intermediate steps before producing a final output in training and inference phases. Through multiple training stages, the model first learns to align its reasoning with accurate decision paths by optimizing the log odds between preferred and non-preferred responses. During this process, PRefLexOR builds a dynamic knowledge graph by generating questions from random text chunks and retrieval-augmentation to contextualize relevant details from the entire training corpus. In the second stage, preference optimization enhances model performance by using rejection sampling to fine-tune reasoning quality by continually producing in-situ training data while masking the reasoning steps. Recursive optimization within a thinking token framework introduces iterative feedback loops, where the model refines reasoning, achieving deeper coherence, consistency, and adaptability. Implemented in small language models with only 3 billion parameters, we should that even tiny models can iteratively teach themselves to reason with greater depth and reflectivity. Our implementation is straightforward and can be incorporated into any existing pretrained LLM. We focus our examples on applications in biological materials science and demonstrate the method in a variety of case studies that range from in-domain to cross-domain applications. Using reasoning strategies that include thinking and reflection modalities we build a multi-agent recursive self-improving inference approach to successively improve responses via repeated sampling in inference time.

The growing popularity of neuro symbolic reasoning has led to the adoption of various forms of differentiable (i.e., fuzzy) first order logic. We introduce PyReason, a software framework based on generalized annotated logic that both captures the current cohort of differentiable logics and temporal extensions to support inference over finite periods of time with capabilities for open world reasoning. Further, PyReason is implemented to directly support reasoning over graphical structures (e.g., knowledge graphs, social networks, biological networks, etc.), produces fully explainable traces of inference, and includes various practical features such as type checking and a memory-efficient implementation. This paper reviews various extensions of generalized annotated logic integrated into our implementation, our modern, efficient Python-based implementation that conducts exact yet scalable deductive inference, and a suite of experiments. PyReason is available at: github.com/lab-v2/pyreason.

Large Language Models (LLMs) significantly benefit from Chain-of-Thought (CoT) prompting in performing various reasoning tasks. While CoT allows models to produce more comprehensive reasoning processes, its emphasis on intermediate reasoning steps can inadvertently introduce hallucinations and accumulated errors, thereby limiting models' ability to solve complex reasoning tasks. Inspired by how humans engage in careful and meticulous deductive logical reasoning processes to solve tasks, we seek to enable language models to perform explicit and rigorous deductive reasoning, and also ensure the trustworthiness of their reasoning process through self-verification. However, directly verifying the validity of an entire deductive reasoning process is challenging, even with advanced models like ChatGPT. In light of this, we propose to decompose a reasoning verification process into a series of step-by-step subprocesses, each only receiving their necessary context and premises. To facilitate this procedure, we propose Natural Program, a natural language-based deductive reasoning format. Our approach enables models to generate precise reasoning steps where subsequent steps are more rigorously grounded on prior steps. It also empowers language models to carry out reasoning self-verification in a step-by-step manner. By integrating this verification process into each deductive reasoning stage, we significantly enhance the rigor and trustfulness of generated reasoning steps. Along this process, we also improve the answer correctness on complex reasoning tasks. Code will be released at https://github.com/lz1oceani/verify_cot.

A digital twin is a virtual replica of a real-world physical phenomena that uses mathematical modeling to characterize and simulate its defining features. By constructing digital twins for disease processes, we can perform in-silico simulations that mimic patients' health conditions and counterfactual outcomes under hypothetical interventions in a virtual setting. This eliminates the need for invasive procedures or uncertain treatment decisions. In this paper, we propose a method to identify digital twin model parameters using only noninvasive patient health data. We approach the digital twin modeling as a composite inverse problem, and observe that its structure resembles pretraining and finetuning in self-supervised learning (SSL). Leveraging this, we introduce a physics-informed SSL algorithm that initially pretrains a neural network on the pretext task of solving the physical model equations. Subsequently, the model is trained to reconstruct low-dimensional health measurements from noninvasive modalities while being constrained by the physical equations learned in pretraining. We apply our method to identify digital twins of cardiac hemodynamics using noninvasive echocardiogram videos, and demonstrate its utility in unsupervised disease detection and in-silico clinical trials.

While language models are powerful and versatile, they often fail to address highly complex problems. This is because solving complex problems requires deliberate thinking, which has been only minimally guided during training. In this paper, we propose a new method called Cumulative Reasoning (CR), which employs language models in a cumulative and iterative manner to emulate human thought processes. By decomposing tasks into smaller components, CR streamlines the problem-solving process, rendering it both more manageable and effective. For logical inference tasks, CR consistently outperforms existing methods with an improvement up to 9.3%, and achieves the astonishing accuracy of 98.04% on the curated FOLIO wiki dataset. In the context of the Game of 24, CR achieves an accuracy of 98%, which signifies a substantial enhancement of 24% over the previous state-of-the-art method. Finally, on the MATH dataset, we establish new state-of-the-art results with 58.0% overall accuracy, surpassing the previous best approach by a margin of 4.2%, and achieving 43% relative improvement on the hardest level 5 problems (22.4% to 32.1%). Code is available at https://github.com/iiis-ai/cumulative-reasoning.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

This survey paper proposes a clearer view of natural language reasoning in the field of Natural Language Processing (NLP), both conceptually and practically. Conceptually, we provide a distinct definition for natural language reasoning in NLP, based on both philosophy and NLP scenarios, discuss what types of tasks require reasoning, and introduce a taxonomy of reasoning. Practically, we conduct a comprehensive literature review on natural language reasoning in NLP, mainly covering classical logical reasoning, natural language inference, multi-hop question answering, and commonsense reasoning. The paper also identifies and views backward reasoning, a powerful paradigm for multi-step reasoning, and introduces defeasible reasoning as one of the most important future directions in natural language reasoning research. We focus on single-modality unstructured natural language text, excluding neuro-symbolic techniques and mathematical reasoning.

Diagnosing and managing a patient is a complex, sequential decision making process that requires physicians to obtain information -- such as which tests to perform -- and to act upon it. Recent advances in artificial intelligence (AI) and large language models (LLMs) promise to profoundly impact clinical care. However, current evaluation schemes overrely on static medical question-answering benchmarks, falling short on interactive decision-making that is required in real-life clinical work. Here, we present AgentClinic: a multimodal benchmark to evaluate LLMs in their ability to operate as agents in simulated clinical environments. In our benchmark, the doctor agent must uncover the patient's diagnosis through dialogue and active data collection. We present two open medical agent benchmarks: a multimodal image and dialogue environment, AgentClinic-NEJM, and a dialogue-only environment, AgentClinic-MedQA. We embed cognitive and implicit biases both in patient and doctor agents to emulate realistic interactions between biased agents. We find that introducing bias leads to large reductions in diagnostic accuracy of the doctor agents, as well as reduced compliance, confidence, and follow-up consultation willingness in patient agents. Evaluating a suite of state-of-the-art LLMs, we find that several models that excel in benchmarks like MedQA are performing poorly in AgentClinic-MedQA. We find that the LLM used in the patient agent is an important factor for performance in the AgentClinic benchmark. We show that both having limited interactions as well as too many interaction reduces diagnostic accuracy in doctor agents. The code and data for this work is publicly available at https://AgentClinic.github.io.

Large language models (LLMs) often struggle with maintaining accuracy across a sequence of intermediate reasoning steps in mathematical reasoning, leading to error propagation that undermines the final result. The current methodology to mitigate this issue primarily involves using a verifier model to assess the correctness of generated solution candidates, focusing either on the overall reasoning path or on an incomplete reasoning path. By rethinking this approach, we argue that assessing potentials of incomplete reasoning paths could be more advantageous as it guides towards correct final answers, transforming the task into a planning problem. Our proposed verifier, the Outcome-supervision Value Model (OVM), employs outcome supervision for training, offering an efficient and intuitive method for planning by prioritizing steps that lead to accurate conclusions over mere per-step correctness. Furthermore, the OVM eschews the need for labor-intensive annotations on step-level correctness, enhancing its scalability. Our experiments on two multi-step mathematical reasoning datasets, GSM8K and Game of 24, demonstrate the superior performance of the OVM model. Notably, in GSM8K, our OVM-7B model achieves state-of-the-art results among LLMs up to 13B parameters; especially it does not utilize GPT-4 or code execution. These findings offer a novel perspective on the role of outcome supervision in training verifiers for multi-step reasoning tasks and provide theoretical justification for its advantage in value estimation for planning.

Passively collected behavioral health data from ubiquitous sensors holds significant promise to provide mental health professionals insights from patient's daily lives; however, developing analysis tools to use this data in clinical practice requires addressing challenges of generalization across devices and weak or ambiguous correlations between the measured signals and an individual's mental health. To address these challenges, we take a novel approach that leverages large language models (LLMs) to synthesize clinically useful insights from multi-sensor data. We develop chain of thought prompting methods that use LLMs to generate reasoning about how trends in data such as step count and sleep relate to conditions like depression and anxiety. We first demonstrate binary depression classification with LLMs achieving accuracies of 61.1% which exceed the state of the art. While it is not robust for clinical use, this leads us to our key finding: even more impactful and valued than classification is a new human-AI collaboration approach in which clinician experts interactively query these tools and combine their domain expertise and context about the patient with AI generated reasoning to support clinical decision-making. We find models like GPT-4 correctly reference numerical data 75% of the time, and clinician participants express strong interest in using this approach to interpret self-tracking data.

Recent large language models (LLMs) in the general domain, such as ChatGPT, have shown remarkable success in following instructions and producing human-like responses. However, such language models have not been learned individually and carefully for the medical domain, resulting in poor diagnostic accuracy and inability to give correct recommendations for medical diagnosis, medications, etc. To address this issue, we collected more than 700 diseases and their corresponding symptoms, recommended medications, and required medical tests, and then generated 5K doctor-patient conversations. By fine-tuning models of doctor-patient conversations, these models emerge with great potential to understand patients' needs, provide informed advice, and offer valuable assistance in a variety of medical-related fields. The integration of these advanced language models into healthcare can revolutionize the way healthcare professionals and patients communicate, ultimately improving the overall quality of care and patient outcomes. In addition, we will open all source code, datasets and model weights to advance the further development of dialogue models in the medical field. In addition, the training data, code, and weights of this project are available at: https://github.com/Kent0n-Li/ChatDoctor.

We study the problem of procedure planning in instructional videos, which aims to make a goal-oriented sequence of action steps given partial visual state observations. The motivation of this problem is to learn a structured and plannable state and action space. Recent works succeeded in sequence modeling of steps with only sequence-level annotations accessible during training, which overlooked the roles of states in the procedures. In this work, we point out that State CHangEs MAtter (SCHEMA) for procedure planning in instructional videos. We aim to establish a more structured state space by investigating the causal relations between steps and states in procedures. Specifically, we explicitly represent each step as state changes and track the state changes in procedures. For step representation, we leveraged the commonsense knowledge in large language models (LLMs) to describe the state changes of steps via our designed chain-of-thought prompting. For state change tracking, we align visual state observations with language state descriptions via cross-modal contrastive learning, and explicitly model the intermediate states of the procedure using LLM-generated state descriptions. Experiments on CrossTask, COIN, and NIV benchmark datasets demonstrate that our proposed SCHEMA model achieves state-of-the-art performance and obtains explainable visualizations.

Without relevant human priors, neural networks may learn uninterpretable features. We propose Dynamics of Attention for Focus Transition (DAFT) as a human prior for machine reasoning. DAFT is a novel method that regularizes attention-based reasoning by modelling it as a continuous dynamical system using neural ordinary differential equations. As a proof of concept, we augment a state-of-the-art visual reasoning model with DAFT. Our experiments reveal that applying DAFT yields similar performance to the original model while using fewer reasoning steps, showing that it implicitly learns to skip unnecessary steps. We also propose a new metric, Total Length of Transition (TLT), which represents the effective reasoning step size by quantifying how much a given model's focus drifts while reasoning about a question. We show that adding DAFT results in lower TLT, demonstrating that our method indeed obeys the human prior towards shorter reasoning paths in addition to producing more interpretable attention maps. Our code is available at https://github.com/kakao/DAFT.

As machine learning models become increasingly prevalent in medical diagnostics, the need for interpretability and transparency becomes paramount. The XAI Renaissance signifies a significant shift in the field, aiming to redefine the interpretability of medical diagnostic models. This paper explores the innovative approaches and methodologies within the realm of Explainable AI (XAI) that are revolutionizing the interpretability of medical diagnostic models. By shedding light on the underlying decision-making process, XAI techniques empower healthcare professionals to understand, trust, and effectively utilize these models for accurate and reliable medical diagnoses. This review highlights the key advancements in XAI for medical diagnostics and their potential to transform the healthcare landscape, ultimately improving patient outcomes and fostering trust in AI-driven diagnostic systems.

Step-level reward models (SRMs) can significantly enhance mathematical reasoning performance through process supervision or step-level preference alignment based on reinforcement learning. The performance of SRMs is pivotal, as they serve as critical guidelines, ensuring that each step in the reasoning process is aligned with desired outcomes. Recently, AlphaZero-like methods, where Monte Carlo Tree Search (MCTS) is employed for automatic step-level preference annotation, have proven particularly effective. However, the precise mechanisms behind the success of SRMs remain largely unexplored. To address this gap, this study delves into the counterintuitive aspects of SRMs, particularly focusing on MCTS-based approaches. Our findings reveal that the removal of natural language descriptions of thought processes has minimal impact on the efficacy of SRMs. Furthermore, we demonstrate that SRMs are adept at assessing the complex logical coherence present in mathematical language while having difficulty in natural language. These insights provide a nuanced understanding of the core elements that drive effective step-level reward modeling in mathematical reasoning. By shedding light on these mechanisms, this study offers valuable guidance for developing more efficient and streamlined SRMs, which can be achieved by focusing on the crucial parts of mathematical reasoning.

Using Large Language Models for complex mathematical reasoning is difficult, primarily due to the complexity of multi-step reasoning. The main challenges of this process include (1) selecting critical intermediate results to advance the procedure, and (2) limited exploration of potential solutions. To address these issues, we introduce a novel algorithm, namely Stepwise Self-Consistent Chain-of-Thought (SSC-CoT). SSC-CoT employs a strategy of selecting intermediate steps based on the intersection of various reasoning chains. Additionally, SSC-CoT enables the model to discover critical intermediate steps by querying a knowledge graph comprising relevant domain knowledge. To validate SSC-CoT, we present a new dataset, TriMaster100, tailored for complex trigonometry problems. This dataset contains 100 questions, with each solution broken down into scored intermediate steps, facilitating a comprehensive evaluation of the mathematical reasoning process. On TriMaster100, SSC-CoT triples the effectiveness of the state-of-the-art methods. Furthermore, we benchmark SSC-CoT on the widely recognized complex mathematical question dataset, MATH level 5, and it surpasses the second-best method by 7.2% in accuracy. Code and the TriMaster100 dataset can be found at: https://github.com/zhao-zilong/ssc-cot.

Addressing the discrepancies between predictions and actual outcomes often aids individuals in expanding their thought processes and engaging in reflection, thereby facilitating reasoning in the correct direction. In this paper, we introduce PreAct, an agent framework that integrates prediction with reasoning and action. Leveraging the information provided by predictions, a large language model (LLM) based agent can offer more diversified and strategically oriented reasoning, which in turn leads to more effective actions that help the agent complete complex tasks. Our experiments demonstrate that PreAct outperforms the ReAct approach in accomplishing complex tasks and that PreAct can be co-enhanced when combined with Reflexion methods. We prompt the model with different numbers of historical predictions and find that historical predictions have a sustained positive effect on LLM planning. The differences in single-step reasoning between PreAct and ReAct show that PreAct indeed offers advantages in terms of diversity and strategic directivity over ReAct.

Frontier AI systems, including large language models (LLMs), hold increasing influence over the epistemology of human users. Such influence can reinforce prevailing societal values, potentially contributing to the lock-in of misguided moral beliefs and, consequently, the perpetuation of problematic moral practices on a broad scale. We introduce progress alignment as a technical solution to mitigate this imminent risk. Progress alignment algorithms learn to emulate the mechanics of human moral progress, thereby addressing the susceptibility of existing alignment methods to contemporary moral blindspots. To empower research in progress alignment, we introduce ProgressGym, an experimental framework allowing the learning of moral progress mechanics from history, in order to facilitate future progress in real-world moral decisions. Leveraging 9 centuries of historical text and 18 historical LLMs, ProgressGym enables codification of real-world progress alignment challenges into concrete benchmarks. Specifically, we introduce three core challenges: tracking evolving values (PG-Follow), preemptively anticipating moral progress (PG-Predict), and regulating the feedback loop between human and AI value shifts (PG-Coevolve). Alignment methods without a temporal dimension are inapplicable to these tasks. In response, we present lifelong and extrapolative algorithms as baseline methods of progress alignment, and build an open leaderboard soliciting novel algorithms and challenges. The framework and the leaderboard are available at https://github.com/PKU-Alignment/ProgressGym and https://huggingface.co/spaces/PKU-Alignment/ProgressGym-LeaderBoard respectively.