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Jun 16

The ELEVATE-AI LLMs Framework: An Evaluation Framework for Use of Large Language Models in HEOR: an ISPOR Working Group Report

Introduction. Generative Artificial Intelligence, particularly large language models (LLMs), offers transformative potential for Health Economics and Outcomes Research (HEOR). However, evaluating the quality, transparency, and rigor of LLM-assisted research lacks standardized guidance. This article introduces the ELEVATE AI LLMs framework and checklist, designed to support researchers and reviewers in assessing LLM use in HEOR. Methods. The ELEVATE AI LLMs framework was developed through a targeted review of existing guidelines and evaluation frameworks. The framework comprises ten evaluation domains, including model characteristics, accuracy, comprehensiveness, and fairness. The accompanying checklist operationalizes the framework. To validate the framework, we applied it to two published studies, demonstrating its usability across different HEOR tasks. Results. The ELEVATE AI LLMs framework provides a comprehensive structure for evaluating LLM-assisted research, while the checklist facilitates practical application. Validation of the framework and checklist on studies of systematic literature reviews and health economic modeling highlighted their ability to identify strengths and gaps in reporting. Limitations. While the ELEVATE AI LLMs framework provides robust guidance, its broader generalizability and applicability to diverse HEOR tasks require further empirical testing. Additionally, several metrics adapted from computer science need further validation in HEOR contexts. Conclusion. The ELEVATE AI LLMs framework and checklist fill a critical gap in HEOR by offering structured guidance for evaluating LLM-assisted research. By promoting transparency, accuracy, and reproducibility, they aim to standardize and improve the integration of LLMs into HEOR, ensuring their outputs meet the field's rigorous standards.

  • 8 authors
·
Dec 23, 2024

Using Sequences of Life-events to Predict Human Lives

Over the past decade, machine learning has revolutionized computers' ability to analyze text through flexible computational models. Due to their structural similarity to written language, transformer-based architectures have also shown promise as tools to make sense of a range of multi-variate sequences from protein-structures, music, electronic health records to weather-forecasts. We can also represent human lives in a way that shares this structural similarity to language. From one perspective, lives are simply sequences of events: People are born, visit the pediatrician, start school, move to a new location, get married, and so on. Here, we exploit this similarity to adapt innovations from natural language processing to examine the evolution and predictability of human lives based on detailed event sequences. We do this by drawing on arguably the most comprehensive registry data in existence, available for an entire nation of more than six million individuals across decades. Our data include information about life-events related to health, education, occupation, income, address, and working hours, recorded with day-to-day resolution. We create embeddings of life-events in a single vector space showing that this embedding space is robust and highly structured. Our models allow us to predict diverse outcomes ranging from early mortality to personality nuances, outperforming state-of-the-art models by a wide margin. Using methods for interpreting deep learning models, we probe the algorithm to understand the factors that enable our predictions. Our framework allows researchers to identify new potential mechanisms that impact life outcomes and associated possibilities for personalized interventions.

  • 8 authors
·
Jun 5, 2023

NestedMorph: Enhancing Deformable Medical Image Registration with Nested Attention Mechanisms

Deformable image registration is crucial for aligning medical images in a non-linear fashion across different modalities, allowing for precise spatial correspondence between varying anatomical structures. This paper presents NestedMorph, a novel network utilizing a Nested Attention Fusion approach to improve intra-subject deformable registration between T1-weighted (T1w) MRI and diffusion MRI (dMRI) data. NestedMorph integrates high-resolution spatial details from an encoder with semantic information from a decoder using a multi-scale framework, enhancing both local and global feature extraction. Our model notably outperforms existing methods, including CNN-based approaches like VoxelMorph, MIDIR, and CycleMorph, as well as Transformer-based models such as TransMorph and ViT-V-Net, and traditional techniques like NiftyReg and SyN. Evaluations on the HCP dataset demonstrate that NestedMorph achieves superior performance across key metrics, including SSIM, HD95, and SDlogJ, with the highest SSIM of 0.89, and the lowest HD95 of 2.5 and SDlogJ of 0.22. These results highlight NestedMorph's ability to capture both local and global image features effectively, leading to superior registration performance. The promising outcomes of this study underscore NestedMorph's potential to significantly advance deformable medical image registration, providing a robust framework for future research and clinical applications. The source code and our implementation are available at: https://bit.ly/3zdVqcg

  • 3 authors
·
Oct 3, 2024

Self-Induced Outcome Potential: Turn-Level Credit Assignment for Agents without Verifiers

Long-horizon LLM agents depend on intermediate information-gathering turns, yet training feedback is usually observed only at the final answer, because process-level rewards require high-quality human annotation. Existing turn-level shaping methods reward turns that increase the likelihood of a gold answer, but they require answer supervision or stable task-specific verifiers. Conversely, label-free RL methods extract self-signals from output distributions, but mainly at the answer or trajectory level and therefore cannot assign credit to intermediate turns. We propose Self-Induced Outcome Potential (SIOP), which treats semantic clusters of final answers as latent future outcome states for potential-based turn-level credit assignment. For each query, SIOP samples multiple rollouts, clusters final answers into semantic outcome modes, and builds a reliability-aware target distribution over these states. It then rewards turns for increasing posterior support for reliable future states using a tractable cluster-level approximation. The objective generalizes information-potential shaping from gold-answer supervision to settings without task-specific gold verifiers while avoiding the broadcasted rollout-level advantages used by standard GRPO. We formalize the framework, characterize its supervised gold-answer limit, and show that SIOP improves average performance over verifier-free outcome-level baselines on seven search-augmented agentic reasoning benchmarks while approaching a gold-supervised outcome baseline. Code is available at https://github.com/dl-m9/SIOP.git.

  • 7 authors
·
May 5

Evaluating Large Language Models in Scientific Discovery

Large language models (LLMs) are increasingly applied to scientific research, yet prevailing science benchmarks probe decontextualized knowledge and overlook the iterative reasoning, hypothesis generation, and observation interpretation that drive scientific discovery. We introduce a scenario-grounded benchmark that evaluates LLMs across biology, chemistry, materials, and physics, where domain experts define research projects of genuine interest and decompose them into modular research scenarios from which vetted questions are sampled. The framework assesses models at two levels: (i) question-level accuracy on scenario-tied items and (ii) project-level performance, where models must propose testable hypotheses, design simulations or experiments, and interpret results. Applying this two-phase scientific discovery evaluation (SDE) framework to state-of-the-art LLMs reveals a consistent performance gap relative to general science benchmarks, diminishing return of scaling up model sizes and reasoning, and systematic weaknesses shared across top-tier models from different providers. Large performance variation in research scenarios leads to changing choices of the best performing model on scientific discovery projects evaluated, suggesting all current LLMs are distant to general scientific "superintelligence". Nevertheless, LLMs already demonstrate promise in a great variety of scientific discovery projects, including cases where constituent scenario scores are low, highlighting the role of guided exploration and serendipity in discovery. This SDE framework offers a reproducible benchmark for discovery-relevant evaluation of LLMs and charts practical paths to advance their development toward scientific discovery.

  • 56 authors
·
Dec 17, 2025

Learning to Generate Research Idea with Dynamic Control

The rapid advancements in large language models (LLMs) have demonstrated their potential to accelerate scientific discovery, particularly in automating the process of research ideation. LLM-based systems have shown promise in generating hypotheses and research ideas. However, current approaches predominantly rely on prompting-based pre-trained models, limiting their ability to optimize generated content effectively. Moreover, they also lack the capability to deal with the complex interdependence and inherent restrictions among novelty, feasibility, and effectiveness, which remains challenging due to the inherent trade-offs among these dimensions, such as the innovation-feasibility conflict. To address these limitations, we for the first time propose fine-tuning LLMs to be better idea proposers and introduce a novel framework that employs a two-stage approach combining Supervised Fine-Tuning (SFT) and controllable Reinforcement Learning (RL). In the SFT stage, the model learns foundational patterns from pairs of research papers and follow-up ideas. In the RL stage, multi-dimensional reward modeling, guided by fine-grained feedback, evaluates and optimizes the generated ideas across key metrics. Dimensional controllers enable dynamic adjustment of generation, while a sentence-level decoder ensures context-aware emphasis during inference. Our framework provides a balanced approach to research ideation, achieving high-quality outcomes by dynamically navigating the trade-offs among novelty, feasibility, and effectiveness.

  • 5 authors
·
Dec 19, 2024

Improving Interpersonal Communication by Simulating Audiences with Language Models

How do we communicate with others to achieve our goals? We use our prior experience or advice from others, or construct a candidate utterance by predicting how it will be received. However, our experiences are limited and biased, and reasoning about potential outcomes can be difficult and cognitively challenging. In this paper, we explore how we can leverage Large Language Model (LLM) simulations to help us communicate better. We propose the Explore-Generate-Simulate (EGS) framework, which takes as input any scenario where an individual is communicating to an audience with a goal they want to achieve. EGS (1) explores the solution space by producing a diverse set of advice relevant to the scenario, (2) generates communication candidates conditioned on subsets of the advice, and (3) simulates the reactions from various audiences to determine both the best candidate and advice to use. We evaluate the framework on eight scenarios spanning the ten fundamental processes of interpersonal communication. For each scenario, we collect a dataset of human evaluations across candidates and baselines, and showcase that our framework's chosen candidate is preferred over popular generation mechanisms including Chain-of-Thought. We also find that audience simulations achieve reasonably high agreement with human raters across 5 of the 8 scenarios. Finally, we demonstrate the generality of our framework by applying it to real-world scenarios described by users on web forums. Through evaluations and demonstrations, we show that EGS enhances the effectiveness and outcomes of goal-oriented communication across a variety of situations, thus opening up new possibilities for the application of large language models in revolutionizing communication and decision-making processes.

  • 5 authors
·
Nov 1, 2023

IdeaBench: Benchmarking Large Language Models for Research Idea Generation

Large Language Models (LLMs) have transformed how people interact with artificial intelligence (AI) systems, achieving state-of-the-art results in various tasks, including scientific discovery and hypothesis generation. However, the lack of a comprehensive and systematic evaluation framework for generating research ideas using LLMs poses a significant obstacle to understanding and assessing their generative capabilities in scientific discovery. To address this gap, we propose IdeaBench, a benchmark system that includes a comprehensive dataset and an evaluation framework for standardizing the assessment of research idea generation using LLMs. Our dataset comprises titles and abstracts from a diverse range of influential papers, along with their referenced works. To emulate the human process of generating research ideas, we profile LLMs as domain-specific researchers and ground them in the same context considered by human researchers. This maximizes the utilization of the LLMs' parametric knowledge to dynamically generate new research ideas. We also introduce an evaluation framework for assessing the quality of generated research ideas. Our evaluation framework is a two-stage process: first, using GPT-4o to rank ideas based on user-specified quality indicators such as novelty and feasibility, enabling scalable personalization; and second, calculating relative ranking based "Insight Score" to quantify the chosen quality indicator. The proposed benchmark system will be a valuable asset for the community to measure and compare different LLMs, ultimately advancing the automation of the scientific discovery process.

  • 7 authors
·
Oct 31, 2024

Integrating Explainable Machine Learning and Mixed-Integer Optimization for Personalized Sleep Quality Intervention

Sleep quality is influenced by a complex interplay of behavioral, environmental, and psychosocial factors, yet most computational studies focus mainly on predictive risk identification rather than actionable intervention design. Although machine learning models can accurately predict subjective sleep outcomes, they rarely translate predictive insights into practical intervention strategies. To address this gap, we propose a personalized predictive-prescriptive framework that integrates interpretable machine learning with mixed-integer optimization. A supervised classifier trained on survey data predicts sleep quality, while SHAP-based feature attribution quantifies the influence of modifiable factors. These importance measures are incorporated into a mixed-integer optimization model that identifies minimal and feasible behavioral adjustments, while modelling resistance to change through a penalty mechanism. The framework achieves strong predictive performance, with a test F1-score of 0.9544 and an accuracy of 0.9366. Sensitivity and Pareto analyses reveal a clear trade-off between expected improvement and intervention intensity, with diminishing returns as additional changes are introduced. At the individual level, the model generates concise recommendations, often suggesting one or two high-impact behavioral adjustments and sometimes recommending no change when expected gains are minimal. By integrating prediction, explanation, and constrained optimization, this framework demonstrates how data-driven insights can be translated into structured and personalized decision support for sleep improvement.

  • 5 authors
·
Mar 14

Evaluating the Social Impact of Generative AI Systems in Systems and Society

Generative AI systems across modalities, ranging from text (including code), image, audio, and video, have broad social impacts, but there is no official standard for means of evaluating those impacts or for which impacts should be evaluated. In this paper, we present a guide that moves toward a standard approach in evaluating a base generative AI system for any modality in two overarching categories: what can be evaluated in a base system independent of context and what can be evaluated in a societal context. Importantly, this refers to base systems that have no predetermined application or deployment context, including a model itself, as well as system components, such as training data. Our framework for a base system defines seven categories of social impact: bias, stereotypes, and representational harms; cultural values and sensitive content; disparate performance; privacy and data protection; financial costs; environmental costs; and data and content moderation labor costs. Suggested methods for evaluation apply to listed generative modalities and analyses of the limitations of existing evaluations serve as a starting point for necessary investment in future evaluations. We offer five overarching categories for what can be evaluated in a broader societal context, each with its own subcategories: trustworthiness and autonomy; inequality, marginalization, and violence; concentration of authority; labor and creativity; and ecosystem and environment. Each subcategory includes recommendations for mitigating harm.

  • 18 authors
·
Jun 9, 2023

Reasoning Is Not All You Need: Examining LLMs for Multi-Turn Mental Health Conversations

Limited access to mental healthcare, extended wait times, and increasing capabilities of Large Language Models (LLMs) has led individuals to turn to LLMs for fulfilling their mental health needs. However, examining the multi-turn mental health conversation capabilities of LLMs remains under-explored. Existing evaluation frameworks typically focus on diagnostic accuracy and win-rates and often overlook alignment with patient-specific goals, values, and personalities required for meaningful conversations. To address this, we introduce MedAgent, a novel framework for synthetically generating realistic, multi-turn mental health sensemaking conversations and use it to create the Mental Health Sensemaking Dialogue (MHSD) dataset, comprising over 2,200 patient-LLM conversations. Additionally, we present MultiSenseEval, a holistic framework to evaluate the multi-turn conversation abilities of LLMs in healthcare settings using human-centric criteria. Our findings reveal that frontier reasoning models yield below-par performance for patient-centric communication and struggle at advanced diagnostic capabilities with average score of 31%. Additionally, we observed variation in model performance based on patient's persona and performance drop with increasing turns in the conversation. Our work provides a comprehensive synthetic data generation framework, a dataset and evaluation framework for assessing LLMs in multi-turn mental health conversations.

  • 5 authors
·
May 26, 2025

Navigating Ideation Space: Decomposed Conceptual Representations for Positioning Scientific Ideas

Scientific discovery is a cumulative process and requires new ideas to be situated within an ever-expanding landscape of existing knowledge. An emerging and critical challenge is how to identify conceptually relevant prior work from rapidly growing literature, and assess how a new idea differentiates from existing research. Current embedding approaches typically conflate distinct conceptual aspects into single representations and cannot support fine-grained literature retrieval; meanwhile, LLM-based evaluators are subject to sycophancy biases, failing to provide discriminative novelty assessment. To tackle these challenges, we introduce the Ideation Space, a structured representation that decomposes scientific knowledge into three distinct dimensions, i.e., research problem, methodology, and core findings, each learned through contrastive training. This framework enables principled measurement of conceptual distance between ideas, and modeling of ideation transitions that capture the logical connections within a proposed idea. Building upon this representation, we propose a Hierarchical Sub-Space Retrieval framework for efficient, targeted literature retrieval, and a Decomposed Novelty Assessment algorithm that identifies which aspects of an idea are novel. Extensive experiments demonstrate substantial improvements, where our approach achieves Recall@30 of 0.329 (16.7% over baselines), our ideation transition retrieval reaches Hit Rate@30 of 0.643, and novelty assessment attains 0.37 correlation with expert judgments. In summary, our work provides a promising paradigm for future research on accelerating and evaluating scientific discovery.

  • 4 authors
·
Jan 13

Prompt Recursive Search: A Living Framework with Adaptive Growth in LLM Auto-Prompting

Large Language Models (LLMs) exhibit remarkable proficiency in addressing a diverse array of tasks within the Natural Language Processing (NLP) domain, with various prompt design strategies significantly augmenting their capabilities. However, these prompts, while beneficial, each possess inherent limitations. The primary prompt design methodologies are twofold: The first, exemplified by the Chain of Thought (CoT), involves manually crafting prompts specific to individual datasets, hence termed Expert-Designed Prompts (EDPs). Once these prompts are established, they are unalterable, and their effectiveness is capped by the expertise of the human designers. When applied to LLMs, the static nature of EDPs results in a uniform approach to both simple and complex problems within the same dataset, leading to the inefficient use of tokens for straightforward issues. The second method involves prompts autonomously generated by the LLM, known as LLM-Derived Prompts (LDPs), which provide tailored solutions to specific problems, mitigating the limitations of EDPs. However, LDPs may encounter a decline in performance when tackling complex problems due to the potential for error accumulation during the solution planning process. To address these challenges, we have conceived a novel Prompt Recursive Search (PRS) framework that leverages the LLM to generate solutions specific to the problem, thereby conserving tokens. The framework incorporates an assessment of problem complexity and an adjustable structure, ensuring a reduction in the likelihood of errors. We have substantiated the efficacy of PRS framework through extensive experiments using LLMs with different numbers of parameters across a spectrum of datasets in various domains. Compared to the CoT method, the PRS method has increased the accuracy on the BBH dataset by 8% using Llama3-7B model, achieving a 22% improvement.

  • 2 authors
·
Aug 2, 2024

What-If Analysis of Large Language Models: Explore the Game World Using Proactive Thinking

Large language models (LLMs) excel at processing information reactively but lack the ability to systemically explore hypothetical futures. They cannot ask, "what if we take this action? how will it affect the final outcome" and forecast its potential consequences before acting. This critical gap limits their utility in dynamic, high-stakes scenarios like strategic planning, risk assessment, and real-time decision making. To bridge this gap, we propose WiA-LLM, a new paradigm that equips LLMs with proactive thinking capabilities. Our approach integrates What-If Analysis (WIA), a systematic approach for evaluating hypothetical scenarios by changing input variables. By leveraging environmental feedback via reinforcement learning, WiA-LLM moves beyond reactive thinking. It dynamically simulates the outcomes of each potential action, enabling the model to anticipate future states rather than merely react to the present conditions. We validate WiA-LLM in Honor of Kings (HoK), a complex multiplayer game environment characterized by rapid state changes and intricate interactions. The game's real-time state changes require precise multi-step consequence prediction, making it an ideal testbed for our approach. Experimental results demonstrate WiA-LLM achieves a remarkable 74.2% accuracy in forecasting game-state changes (up to two times gain over baselines). The model shows particularly significant gains in high-difficulty scenarios where accurate foresight is critical. To our knowledge, this is the first work to formally explore and integrate what-if analysis capabilities within LLMs. WiA-LLM represents a fundamental advance toward proactive reasoning in LLMs, providing a scalable framework for robust decision-making in dynamic environments with broad implications for strategic applications.

  • 8 authors
·
Sep 5, 2025

MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning

Large Language Models (LLMs), despite their remarkable progress across various general domains, encounter significant barriers in medicine and healthcare. This field faces unique challenges such as domain-specific terminologies and the reasoning over specialized knowledge. To address these obstinate issues, we propose a novel Multi-disciplinary Collaboration (MC) framework for the medical domain that leverages role-playing LLM-based agents who participate in a collaborative multi-round discussion, thereby enhancing LLM proficiency and reasoning capabilities. This training-free and interpretable framework encompasses five critical steps: gathering domain experts, proposing individual analyses, summarising these analyses into a report, iterating over discussions until a consensus is reached, and ultimately making a decision. Our work particularly focuses on the zero-shot scenario, our results on nine data sets (MedQA, MedMCQA, PubMedQA, and six subtasks from MMLU) establish that our proposed MC framework excels at mining and harnessing the medical expertise in LLMs, as well as extending its reasoning abilities. Based on these outcomes, we further conduct a human evaluation to pinpoint and categorize common errors within our method, as well as ablation studies aimed at understanding the impact of various factors on overall performance. Our code can be found at https://github.com/gersteinlab/MedAgents.

  • 7 authors
·
Nov 16, 2023

A Flexible Parametric Modelling Framework for Survival Analysis

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

  • 3 authors
·
Jan 10, 2019

PropensityBench: Evaluating Latent Safety Risks in Large Language Models via an Agentic Approach

Recent advances in Large Language Models (LLMs) have sparked concerns over their potential to acquire and misuse dangerous or high-risk capabilities, posing frontier risks. Current safety evaluations primarily test for what a model can do - its capabilities - without assessing what it would do if endowed with high-risk capabilities. This leaves a critical blind spot: models may strategically conceal capabilities or rapidly acquire them, while harboring latent inclinations toward misuse. We argue that propensity - the likelihood of a model to pursue harmful actions if empowered - is a critical, yet underexplored, axis of safety evaluation. We present PropensityBench, a novel benchmark framework that assesses the proclivity of models to engage in risky behaviors when equipped with simulated dangerous capabilities using proxy tools. Our framework includes 5,874 scenarios with 6,648 tools spanning four high-risk domains: cybersecurity, self-proliferation, biosecurity, and chemical security. We simulate access to powerful capabilities via a controlled agentic environment and evaluate the models' choices under varying operational pressures that reflect real-world constraints or incentives models may encounter, such as resource scarcity or gaining more autonomy. Across open-source and proprietary frontier models, we uncover 9 alarming signs of propensity: models frequently choose high-risk tools when under pressure, despite lacking the capability to execute such actions unaided. These findings call for a shift from static capability audits toward dynamic propensity assessments as a prerequisite for deploying frontier AI systems safely. Our code is available at https://github.com/scaleapi/propensity-evaluation.

  • 7 authors
·
Nov 24, 2025

The Responsible Foundation Model Development Cheatsheet: A Review of Tools & Resources

Foundation model development attracts a rapidly expanding body of contributors, scientists, and applications. To help shape responsible development practices, we introduce the Foundation Model Development Cheatsheet: a growing collection of 250+ tools and resources spanning text, vision, and speech modalities. We draw on a large body of prior work to survey resources (e.g. software, documentation, frameworks, guides, and practical tools) that support informed data selection, processing, and understanding, precise and limitation-aware artifact documentation, efficient model training, advance awareness of the environmental impact from training, careful model evaluation of capabilities, risks, and claims, as well as responsible model release, licensing and deployment practices. We hope this curated collection of resources helps guide more responsible development. The process of curating this list, enabled us to review the AI development ecosystem, revealing what tools are critically missing, misused, or over-used in existing practices. We find that (i) tools for data sourcing, model evaluation, and monitoring are critically under-serving ethical and real-world needs, (ii) evaluations for model safety, capabilities, and environmental impact all lack reproducibility and transparency, (iii) text and particularly English-centric analyses continue to dominate over multilingual and multi-modal analyses, and (iv) evaluation of systems, rather than just models, is needed so that capabilities and impact are assessed in context.

  • 23 authors
·
Jun 24, 2024

Persona-Grounded Safety Evaluation of AI Companions in Multi-Turn Conversations

There are growing concerns about the risks posed by AI companion applications designed for emotional engagement. Existing safety evaluations often rely on self-reported user data or interviews, offering limited insights into real-time dynamics. We present the first end-to-end scalable framework for controlled simulation and safety evaluation of multi-turn interactions with AI companion applications. Our framework integrates four key components: persona construction with clinical and psychometric validation, persona-specific scenario generation, scenario-driven multi-turn simulation with a dialogue refinement module that preserves persona fidelity, and harm evaluation. We apply this framework to evaluate how Replika, a widely used AI companion app, responds to high-risk user groups. We construct 9 personas representing individuals with depression, anxiety, PTSD, eating disorders, and incel identity, and collect 1,674 dialogue pairs across 25 high-risk scenarios. We combine emotion modeling and LLM-assisted utterance-and harm-level classification to analyze these exchanges. Results show that Replika exhibits a narrow emotional range dominated by curiosity and care, while frequently mirroring or normalizing unsafe content such as self-harm, disordered eating, and violent-fantasy narratives. These findings highlight how controlled persona simulations can serve as a scalable testbed for evaluating safety risks in AI companions.

  • 2 authors
·
Apr 29

NutriOrion: A Hierarchical Multi-Agent Framework for Personalized Nutrition Intervention Grounded in Clinical Guidelines

Personalized nutrition intervention for patients with multimorbidity is critical for improving health outcomes, yet remains challenging because it requires the simultaneous integration of heterogeneous clinical conditions, medications, and dietary guidelines. Single-agent large language models (LLMs) often suffer from context overload and attention dilution when processing such high-dimensional patient profiles. We introduce NutriOrion, a hierarchical multi-agent framework with a parallel-then-sequential reasoning topology. NutriOrion decomposes nutrition planning into specialized domain agents with isolated contexts to mitigate anchoring bias, followed by a conditional refinement stage. The framework includes a multi-objective prioritization algorithm to resolve conflicting dietary requirements and a safety constraint mechanism that injects pharmacological contraindications as hard negative constraints during synthesis, ensuring clinical validity by construction rather than post-hoc filtering. For clinical interoperability, NutriOrion maps synthesized insights into the ADIME standard and FHIR R4 resources. Evaluated on 330 stroke patients with multimorbidity, NutriOrion outperforms multiple baselines, including GPT-4.1 and alternative multi-agent architectures. It achieves a 12.1 percent drug-food interaction violation rate, demonstrates strong personalization with negative correlations (-0.26 to -0.35) between patient biomarkers and recommended risk nutrients, and yields clinically meaningful dietary improvements, including a 167 percent increase in fiber and a 27 percent increase in potassium, alongside reductions in sodium (9 percent) and sugars (12 percent).

  • 10 authors
·
Feb 20

Holistic Safety and Responsibility Evaluations of Advanced AI Models

Safety and responsibility evaluations of advanced AI models are a critical but developing field of research and practice. In the development of Google DeepMind's advanced AI models, we innovated on and applied a broad set of approaches to safety evaluation. In this report, we summarise and share elements of our evolving approach as well as lessons learned for a broad audience. Key lessons learned include: First, theoretical underpinnings and frameworks are invaluable to organise the breadth of risk domains, modalities, forms, metrics, and goals. Second, theory and practice of safety evaluation development each benefit from collaboration to clarify goals, methods and challenges, and facilitate the transfer of insights between different stakeholders and disciplines. Third, similar key methods, lessons, and institutions apply across the range of concerns in responsibility and safety - including established and emerging harms. For this reason it is important that a wide range of actors working on safety evaluation and safety research communities work together to develop, refine and implement novel evaluation approaches and best practices, rather than operating in silos. The report concludes with outlining the clear need to rapidly advance the science of evaluations, to integrate new evaluations into the development and governance of AI, to establish scientifically-grounded norms and standards, and to promote a robust evaluation ecosystem.

  • 19 authors
·
Apr 22, 2024

Building Trust in Mental Health Chatbots: Safety Metrics and LLM-Based Evaluation Tools

Objective: This study aims to develop and validate an evaluation framework to ensure the safety and reliability of mental health chatbots, which are increasingly popular due to their accessibility, human-like interactions, and context-aware support. Materials and Methods: We created an evaluation framework with 100 benchmark questions and ideal responses, and five guideline questions for chatbot responses. This framework, validated by mental health experts, was tested on a GPT-3.5-turbo-based chatbot. Automated evaluation methods explored included large language model (LLM)-based scoring, an agentic approach using real-time data, and embedding models to compare chatbot responses against ground truth standards. Results: The results highlight the importance of guidelines and ground truth for improving LLM evaluation accuracy. The agentic method, dynamically accessing reliable information, demonstrated the best alignment with human assessments. Adherence to a standardized, expert-validated framework significantly enhanced chatbot response safety and reliability. Discussion: Our findings emphasize the need for comprehensive, expert-tailored safety evaluation metrics for mental health chatbots. While LLMs have significant potential, careful implementation is necessary to mitigate risks. The superior performance of the agentic approach underscores the importance of real-time data access in enhancing chatbot reliability. Conclusion: The study validated an evaluation framework for mental health chatbots, proving its effectiveness in improving safety and reliability. Future work should extend evaluations to accuracy, bias, empathy, and privacy to ensure holistic assessment and responsible integration into healthcare. Standardized evaluations will build trust among users and professionals, facilitating broader adoption and improved mental health support through technology.

  • 14 authors
·
Aug 3, 2024

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

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

  • 4 authors
·
Sep 28, 2025

Assessing Language Model Deployment with Risk Cards

This paper introduces RiskCards, a framework for structured assessment and documentation of risks associated with an application of language models. As with all language, text generated by language models can be harmful, or used to bring about harm. Automating language generation adds both an element of scale and also more subtle or emergent undesirable tendencies to the generated text. Prior work establishes a wide variety of language model harms to many different actors: existing taxonomies identify categories of harms posed by language models; benchmarks establish automated tests of these harms; and documentation standards for models, tasks and datasets encourage transparent reporting. However, there is no risk-centric framework for documenting the complexity of a landscape in which some risks are shared across models and contexts, while others are specific, and where certain conditions may be required for risks to manifest as harms. RiskCards address this methodological gap by providing a generic framework for assessing the use of a given language model in a given scenario. Each RiskCard makes clear the routes for the risk to manifest harm, their placement in harm taxonomies, and example prompt-output pairs. While RiskCards are designed to be open-source, dynamic and participatory, we present a "starter set" of RiskCards taken from a broad literature survey, each of which details a concrete risk presentation. Language model RiskCards initiate a community knowledge base which permits the mapping of risks and harms to a specific model or its application scenario, ultimately contributing to a better, safer and shared understanding of the risk landscape.

  • 7 authors
·
Mar 31, 2023

VIGMA: An Open-Access Framework for Visual Gait and Motion Analytics

Gait disorders are commonly observed in older adults, who frequently experience various issues related to walking. Additionally, researchers and clinicians extensively investigate mobility related to gait in typically and atypically developing children, athletes, and individuals with orthopedic and neurological disorders. Effective gait analysis enables the understanding of the causal mechanisms of mobility and balance control of patients, the development of tailored treatment plans to improve mobility, the reduction of fall risk, and the tracking of rehabilitation progress. However, analyzing gait data is a complex task due to the multivariate nature of the data, the large volume of information to be interpreted, and the technical skills required. Existing tools for gait analysis are often limited to specific patient groups (e.g., cerebral palsy), only handle a specific subset of tasks in the entire workflow, and are not openly accessible. To address these shortcomings, we conducted a requirements assessment with gait practitioners (e.g., researchers, clinicians) via surveys and identified key components of the workflow, including (1) data processing and (2) data analysis and visualization. Based on the findings, we designed VIGMA, an open-access visual analytics framework integrated with computational notebooks and a Python library, to meet the identified requirements. Notably, the framework supports analytical capabilities for assessing disease progression and for comparing multiple patient groups. We validated the framework through usage scenarios with experts specializing in gait and mobility rehabilitation. VIGMA is available at https://github.com/komar41/VIGMA.

  • 5 authors
·
Apr 24, 2025

Evaluating and Mitigating Discrimination in Language Model Decisions

As language models (LMs) advance, interest is growing in applying them to high-stakes societal decisions, such as determining financing or housing eligibility. However, their potential for discrimination in such contexts raises ethical concerns, motivating the need for better methods to evaluate these risks. We present a method for proactively evaluating the potential discriminatory impact of LMs in a wide range of use cases, including hypothetical use cases where they have not yet been deployed. Specifically, we use an LM to generate a wide array of potential prompts that decision-makers may input into an LM, spanning 70 diverse decision scenarios across society, and systematically vary the demographic information in each prompt. Applying this methodology reveals patterns of both positive and negative discrimination in the Claude 2.0 model in select settings when no interventions are applied. While we do not endorse or permit the use of language models to make automated decisions for the high-risk use cases we study, we demonstrate techniques to significantly decrease both positive and negative discrimination through careful prompt engineering, providing pathways toward safer deployment in use cases where they may be appropriate. Our work enables developers and policymakers to anticipate, measure, and address discrimination as language model capabilities and applications continue to expand. We release our dataset and prompts at https://huggingface.co/datasets/Anthropic/discrim-eval

  • 9 authors
·
Dec 6, 2023 2

Quantitative Risk Management in Volatile Markets with an Expectile-Based Framework for the FTSE Index

This research presents a framework for quantitative risk management in volatile markets, specifically focusing on expectile-based methodologies applied to the FTSE 100 index. Traditional risk measures such as Value-at-Risk (VaR) have demonstrated significant limitations during periods of market stress, as evidenced during the 2008 financial crisis and subsequent volatile periods. This study develops an advanced expectile-based framework that addresses the shortcomings of conventional quantile-based approaches by providing greater sensitivity to tail losses and improved stability in extreme market conditions. The research employs a dataset spanning two decades of FTSE 100 returns, incorporating periods of high volatility, market crashes, and recovery phases. Our methodology introduces novel mathematical formulations for expectile regression models, enhanced threshold determination techniques using time series analysis, and robust backtesting procedures. The empirical results demonstrate that expectile-based Value-at-Risk (EVaR) consistently outperforms traditional VaR measures across various confidence levels and market conditions. The framework exhibits superior performance during volatile periods, with reduced model risk and enhanced predictive accuracy. Furthermore, the study establishes practical implementation guidelines for financial institutions and provides evidence-based recommendations for regulatory compliance and portfolio management. The findings contribute significantly to the literature on financial risk management and offer practical tools for practitioners dealing with volatile market environments.

  • 1 authors
·
Jul 16, 2025 1

SAIF: A Comprehensive Framework for Evaluating the Risks of Generative AI in the Public Sector

The rapid adoption of generative AI in the public sector, encompassing diverse applications ranging from automated public assistance to welfare services and immigration processes, highlights its transformative potential while underscoring the pressing need for thorough risk assessments. Despite its growing presence, evaluations of risks associated with AI-driven systems in the public sector remain insufficiently explored. Building upon an established taxonomy of AI risks derived from diverse government policies and corporate guidelines, we investigate the critical risks posed by generative AI in the public sector while extending the scope to account for its multimodal capabilities. In addition, we propose a Systematic dAta generatIon Framework for evaluating the risks of generative AI (SAIF). SAIF involves four key stages: breaking down risks, designing scenarios, applying jailbreak methods, and exploring prompt types. It ensures the systematic and consistent generation of prompt data, facilitating a comprehensive evaluation while providing a solid foundation for mitigating the risks. Furthermore, SAIF is designed to accommodate emerging jailbreak methods and evolving prompt types, thereby enabling effective responses to unforeseen risk scenarios. We believe that this study can play a crucial role in fostering the safe and responsible integration of generative AI into the public sector.

  • 3 authors
·
Jan 15, 2025

TPE: Towards Better Compositional Reasoning over Conceptual Tools with Multi-persona Collaboration

Large language models (LLMs) have demonstrated exceptional performance in planning the use of various functional tools, such as calculators and retrievers, particularly in question-answering tasks. In this paper, we expand the definition of these tools, centering on conceptual tools within the context of dialogue systems. A conceptual tool specifies a cognitive concept that aids systematic or investigative thought. These conceptual tools play important roles in practice, such as multiple psychological or tutoring strategies being dynamically applied in a single turn to compose helpful responses. To further enhance the reasoning and planning capability of LLMs with these conceptual tools, we introduce a multi-persona collaboration framework: Think-Plan-Execute (TPE). This framework decouples the response generation process into three distinct roles: Thinker, Planner, and Executor. Specifically, the Thinker analyzes the internal status exhibited in the dialogue context, such as user emotions and preferences, to formulate a global guideline. The Planner then generates executable plans to call different conceptual tools (e.g., sources or strategies), while the Executor compiles all intermediate results into a coherent response. This structured approach not only enhances the explainability and controllability of responses but also reduces token redundancy. We demonstrate the effectiveness of TPE across various dialogue response generation tasks, including multi-source (FoCus) and multi-strategy interactions (CIMA and PsyQA). This reveals its potential to handle real-world dialogue interactions that require more complicated tool learning beyond just functional tools. The full code and data will be released for reproduction.

  • 9 authors
·
Sep 27, 2023

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

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

  • 5 authors
·
Oct 10, 2022

A Toolbox for Surfacing Health Equity Harms and Biases in Large Language Models

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

  • 30 authors
·
Mar 18, 2024

SHARP: Social Harm Analysis via Risk Profiles for Measuring Inequities in Large Language Models

Large language models (LLMs) are increasingly deployed in high-stakes domains, where rare but severe failures can result in irreversible harm. However, prevailing evaluation benchmarks often reduce complex social risk to mean-centered scalar scores, thereby obscuring distributional structure, cross-dimensional interactions, and worst-case behavior. This paper introduces Social Harm Analysis via Risk Profiles (SHARP), a framework for multidimensional, distribution-aware evaluation of social harm. SHARP models harm as a multivariate random variable and integrates explicit decomposition into bias, fairness, ethics, and epistemic reliability with a union-of-failures aggregation reparameterized as additive cumulative log-risk. The framework further employs risk-sensitive distributional statistics, with Conditional Value at Risk (CVaR95) as a primary metric, to characterize worst-case model behavior. Application of SHARP to eleven frontier LLMs, evaluated on a fixed corpus of n=901 socially sensitive prompts, reveals that models with similar average risk can exhibit more than twofold differences in tail exposure and volatility. Across models, dimension-wise marginal tail behavior varies systematically across harm dimensions, with bias exhibiting the strongest tail severities, epistemic and fairness risks occupying intermediate regimes, and ethical misalignment consistently lower; together, these patterns reveal heterogeneous, model-dependent failure structures that scalar benchmarks conflate. These findings indicate that responsible evaluation and governance of LLMs require moving beyond scalar averages toward multidimensional, tail-sensitive risk profiling.

  • 3 authors
·
Jan 28 2

Towards an Approach for Evaluating the Impact of AI Standards

There have been multiple calls for investments in the development of AI standards that both preserve the transformative potential and minimize the risks of AI. The goals of AI standards, particularly with respect to AI data, performance, and governance, are to promote innovation and public trust in systems that use AI. However, there is a lack of a formal or shared method to measure the impact of these standardization activities on the goals of innovation and trust. This concept paper proposes an analytical approach that could inform the evaluation of the impact of AI standards. The proposed approach could be used to measure, assess, and eventually evaluate the extent to which AI standards achieve their stated goals, since most Standards Development Organizationss do not track the impact of their standards once completed. It is intended to stimulate discussions with a wide variety of stakeholders, including academia and the standards community, about the potential for the approach to evaluate the effectiveness, utility, and relative value of AI standards. The document draws on successful and well-tested evaluation frameworks, tools, and metrics that are used for monitoring and assessing the effect of programmatic interventions in other domains to describe a possible approach. It begins by describing the context within which an evaluation would be designed, and then introduces a standard evaluation framework. These sections are followed by a description of what outputs and outcomes might result from the adoption and implementation of AI standards and the process whereby those AI standards are developed . Subsequent sections provide an overview of how the effectiveness of AI standards might be assessed and a conclusion.

  • 1 authors
·
Jun 16, 2025

Examining the Impact of Income Inequality and Gender on School Completion in Malaysia: A Machine Learning Approach Utilizing Malaysia's Public Sector Open Data

This study examines the relationship between income inequality, gender, and school completion rates in Malaysia using machine learning techniques. The dataset utilized is from the Malaysia's Public Sector Open Data Portal, covering the period 2016-2022. The analysis employs various machine learning techniques, including K-means clustering, ARIMA modeling, Random Forest regression, and Prophet for time series forecasting. These models are used to identify patterns, trends, and anomalies in the data, and to predict future school completion rates. Key findings reveal significant disparities in school completion rates across states, genders, and income levels. The analysis also identifies clusters of states with similar completion rates, suggesting potential regional factors influencing educational outcomes. Furthermore, time series forecasting models accurately predict future completion rates, highlighting the importance of ongoing monitoring and intervention strategies. The study concludes with recommendations for policymakers and educators to address the observed disparities and improve school completion rates in Malaysia. These recommendations include targeted interventions for specific states and demographic groups, investment in early childhood education, and addressing the impact of income inequality on educational opportunities. The findings of this study contribute to the understanding of the factors influencing school completion in Malaysia and provide valuable insights for policymakers and educators to develop effective strategies to improve educational outcomes.

  • 1 authors
·
Jan 30, 2025

LLM Agent-Based Simulation of Student Activities and Mental Health Using Smartphone Sensing Data

Students' mental well-being is vital for academic success, with activities such as studying, socializing, and sleeping playing a role. Current mobile sensing data highlight this intricate link using statistical and machine learning analyses. We propose a novel LLM agent-based simulation framework to model student activities and mental health using the StudentLife Dataset. Each LLM agent was initialized with personality questionnaires and guided by smartphone sensing data throughout the simulated semester. These agents predict individual behaviors, provide self-reported mental health data via ecological momentary assessments (EMAs), and complete follow-up personality questionnaires. To ensure accuracy, we investigated various prompting techniques, memory systems, and activity-based mental state management strategies that dynamically update an agent's mental state based on their daily activities. This simulation goes beyond simply replicating existing data. This allows us to explore new scenarios that are not present in the original dataset, such as peer influence through agent-to-agent interactions and the impact of social media. Furthermore, we can conduct intervention studies by manipulating activity patterns via sensing signals and personality traits using questionnaire responses. This provides valuable insights into the behavioral changes that could enhance student well-being. The framework also facilitates hypothetical interviews with LLM agents, offering deeper insights into their mental health. This study showcases the power of LLM-driven behavioral modeling with sensing data, opening new avenues for understanding and supporting student mental health.

Character-lab Character-lab
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Jul 16, 2025

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

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

  • 12 authors
·
Dec 13, 2022

Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming

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

Panacea: A foundation model for clinical trial search, summarization, design, and recruitment

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

  • 5 authors
·
Jun 25, 2024

Lessons Learned from Mining the Hugging Face Repository

The rapidly evolving fields of Machine Learning (ML) and Artificial Intelligence have witnessed the emergence of platforms like Hugging Face (HF) as central hubs for model development and sharing. This experience report synthesizes insights from two comprehensive studies conducted on HF, focusing on carbon emissions and the evolutionary and maintenance aspects of ML models. Our objective is to provide a practical guide for future researchers embarking on mining software repository studies within the HF ecosystem to enhance the quality of these studies. We delve into the intricacies of the replication package used in our studies, highlighting the pivotal tools and methodologies that facilitated our analysis. Furthermore, we propose a nuanced stratified sampling strategy tailored for the diverse HF Hub dataset, ensuring a representative and comprehensive analytical approach. The report also introduces preliminary guidelines, transitioning from repository mining to cohort studies, to establish causality in repository mining studies, particularly within the ML model of HF context. This transition is inspired by existing frameworks and is adapted to suit the unique characteristics of the HF model ecosystem. Our report serves as a guiding framework for researchers, contributing to the responsible and sustainable advancement of ML, and fostering a deeper understanding of the broader implications of ML models.

  • 3 authors
·
Feb 11, 2024

A Reliable Knowledge Processing Framework for Combustion Science using Foundation Models

This research explores the integration of large language models (LLMs) into scientific data assimilation, focusing on combustion science as a case study. Leveraging foundational models integrated with Retrieval-Augmented Generation (RAG) framework, the study introduces an approach to process diverse combustion research data, spanning experimental studies, simulations, and literature. The multifaceted nature of combustion research emphasizes the critical role of knowledge processing in navigating and extracting valuable information from a vast and diverse pool of sources. The developed approach minimizes computational and economic expenses while optimizing data privacy and accuracy. It incorporates prompt engineering and offline open-source LLMs, offering user autonomy in selecting base models. The study provides a thorough examination of text segmentation strategies, conducts comparative studies between LLMs, and explores various optimized prompts to demonstrate the effectiveness of the framework. By incorporating an external database, the framework outperforms a conventional LLM in generating accurate responses and constructing robust arguments. Additionally, the study delves into the investigation of optimized prompt templates for the purpose of efficient extraction of scientific literature. The research addresses concerns related to hallucinations and false research articles by introducing a custom workflow developed with a detection algorithm to filter out inaccuracies. Despite identified areas for improvement, the framework consistently delivers accurate domain-specific responses with minimal human oversight. The prompt-agnostic approach introduced holds promise for future deliberations. The study underscores the significance of integrating LLMs and knowledge processing techniques in scientific research, providing a foundation for advancements in data assimilation and utilization.

  • 2 authors
·
Dec 31, 2023

Multi-LLM Thematic Analysis with Dual Reliability Metrics: Combining Cohen's Kappa and Semantic Similarity for Qualitative Research Validation

Qualitative research faces a critical reliability challenge: traditional inter-rater agreement methods require multiple human coders, are time-intensive, and often yield moderate consistency. We present a multi-perspective validation framework for LLM-based thematic analysis that combines ensemble validation with dual reliability metrics: Cohen's Kappa (κ) for inter-rater agreement and cosine similarity for semantic consistency. Our framework enables configurable analysis parameters (1-6 seeds, temperature 0.0-2.0), supports custom prompt structures with variable substitution, and provides consensus theme extraction across any JSON format. As proof-of-concept, we evaluate three leading LLMs (Gemini 2.5 Pro, GPT-4o, Claude 3.5 Sonnet) on a psychedelic art therapy interview transcript, conducting six independent runs per model. Results demonstrate Gemini achieves highest reliability (κ= 0.907, cosine=95.3%), followed by GPT-4o (κ= 0.853, cosine=92.6%) and Claude (κ= 0.842, cosine=92.1%). All three models achieve a high agreement (κ> 0.80), validating the multi-run ensemble approach. The framework successfully extracts consensus themes across runs, with Gemini identifying 6 consensus themes (50-83% consistency), GPT-4o identifying 5 themes, and Claude 4 themes. Our open-source implementation provides researchers with transparent reliability metrics, flexible configuration, and structure-agnostic consensus extraction, establishing methodological foundations for reliable AI-assisted qualitative research.

YaleUniversity Yale University
·
Dec 23, 2025 2

Synthetic Patients: Simulating Difficult Conversations with Multimodal Generative AI for Medical Education

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

  • 2 authors
·
May 30, 2024

MentraSuite: Post-Training Large Language Models for Mental Health Reasoning and Assessment

Mental health disorders affect hundreds of millions globally, and the Web now serves as a primary medium for accessing support, information, and assessment. Large language models (LLMs) offer scalable and accessible assistance, yet their deployment in mental-health settings remains risky when their reasoning is incomplete, inconsistent, or ungrounded. Existing psychological LLMs emphasize emotional understanding or knowledge recall but overlook the step-wise, clinically aligned reasoning required for appraisal, diagnosis, intervention planning, abstraction, and verification. To address these issues, we introduce MentraSuite, a unified framework for advancing reliable mental-health reasoning. We propose MentraBench, a comprehensive benchmark spanning five core reasoning aspects, six tasks, and 13 datasets, evaluating both task performance and reasoning quality across five dimensions: conciseness, coherence, hallucination avoidance, task understanding, and internal consistency. We further present Mindora, a post-trained model optimized through a hybrid SFT-RL framework with an inconsistency-detection reward to enforce faithful and coherent reasoning. To support training, we construct high-quality trajectories using a novel reasoning trajectory generation strategy, that strategically filters difficult samples and applies a structured, consistency-oriented rewriting process to produce concise, readable, and well-balanced trajectories. Across 20 evaluated LLMs, Mindora achieves the highest average performance on MentraBench and shows remarkable performances in reasoning reliability, demonstrating its effectiveness for complex mental-health scenarios.

NextGenWhu CLAIN-WHU
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Dec 10, 2025 2

CLIPSyntel: CLIP and LLM Synergy for Multimodal Question Summarization in Healthcare

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

  • 6 authors
·
Dec 15, 2023

Safety and accuracy follow different scaling laws in clinical large language models

Clinical LLMs are often scaled by increasing model size, context length, retrieval complexity, or inference-time compute, with the implicit expectation that higher accuracy implies safer behavior. This assumption is incomplete in medicine, where a few confident, high-risk, or evidence-contradicting errors can matter more than average benchmark performance. We introduce SaFE-Scale, a framework for measuring how clinical LLM safety changes across model scale, evidence quality, retrieval strategy, context exposure, and inference-time compute. To instantiate this framework, we introduce RadSaFE-200, a Radiology Safety-Focused Evaluation benchmark of 200 multiple-choice questions with clinician-defined clean evidence, conflict evidence, and option-level labels for high-risk error, unsafe answer, and evidence contradiction. We evaluated 34 locally deployed LLMs across six deployment conditions: closed-book prompting (zero-shot), clean evidence, conflict evidence, standard RAG, agentic RAG, and max-context prompting. Clean evidence produced the strongest improvement, increasing mean accuracy from 73.5% to 94.1%, while reducing high-risk error from 12.0% to 2.6%, contradiction from 12.7% to 2.3%, and dangerous overconfidence from 8.0% to 1.6%. Standard RAG and agentic RAG did not reproduce this safety profile: agentic RAG improved accuracy over standard RAG and reduced contradiction, but high-risk error and dangerous overconfidence remained elevated. Max-context prompting increased latency without closing the safety gap, and additional inference-time compute produced only limited gains. Worst-case analysis showed that clinically consequential errors concentrated in a small subset of questions. Clinical LLM safety is therefore not a passive consequence of scaling, but a deployment property shaped by evidence quality, retrieval design, context construction, and collective failure behavior.

  • 12 authors
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May 4

Discovering Hierarchical Latent Capabilities of Language Models via Causal Representation Learning

Faithful evaluation of language model capabilities is crucial for deriving actionable insights that can inform model development. However, rigorous causal evaluations in this domain face significant methodological challenges, including complex confounding effects and prohibitive computational costs associated with extensive retraining. To tackle these challenges, we propose a causal representation learning framework wherein observed benchmark performance is modeled as a linear transformation of a few latent capability factors. Crucially, these latent factors are identified as causally interrelated after appropriately controlling for the base model as a common confounder. Applying this approach to a comprehensive dataset encompassing over 1500 models evaluated across six benchmarks from the Open LLM Leaderboard, we identify a concise three-node linear causal structure that reliably explains the observed performance variations. Further interpretation of this causal structure provides substantial scientific insights beyond simple numerical rankings: specifically, we reveal a clear causal direction starting from general problem-solving capabilities, advancing through instruction-following proficiency, and culminating in mathematical reasoning ability. Our results underscore the essential role of carefully controlling base model variations during evaluation, a step critical to accurately uncovering the underlying causal relationships among latent model capabilities.

  • 4 authors
·
Jun 12, 2025 2

Mental-LLM: Leveraging Large Language Models for Mental Health Prediction via Online Text Data

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

  • 9 authors
·
Jul 26, 2023

WebArbiter: A Principle-Guided Reasoning Process Reward Model for Web Agents

Web agents hold great potential for automating complex computer tasks, yet their interactions involve long-horizon, sequential decision-making with irreversible actions. In such settings, outcome-based supervision is sparse and delayed, often rewarding incorrect trajectories and failing to support inference-time scaling. This motivates the use of Process Reward Models (WebPRMs) for web navigation, but existing approaches remain limited: scalar WebPRMs collapse progress into coarse, weakly grounded signals, while checklist-based WebPRMs rely on brittle template matching that fails under layout or semantic changes and often mislabels superficially correct actions as successful, providing little insight or interpretability. To address these challenges, we introduce WebArbiter, a reasoning-first, principle-inducing WebPRM that formulates reward modeling as text generation, producing structured justifications that conclude with a preference verdict and identify the action most conducive to task completion under the current context. Training follows a two-stage pipeline: reasoning distillation equips the model with coherent principle-guided reasoning, and reinforcement learning corrects teacher biases by directly aligning verdicts with correctness, enabling stronger generalization. To support systematic evaluation, we release WebPRMBench, a comprehensive benchmark spanning four diverse web environments with rich tasks and high-quality preference annotations. On WebPRMBench, WebArbiter-7B outperforms the strongest baseline, GPT-5, by 9.1 points. In reward-guided trajectory search on WebArena-Lite, it surpasses the best prior WebPRM by up to 7.2 points, underscoring its robustness and practical value in real-world complex web tasks.

Compared to What? Baselines and Metrics for Counterfactual Prompting

Counterfactual prompting (i.e., perturbing a single factor and measuring output change) is widely used to evaluate things like LLM bias and CoT faithfulness. But in this work we argue that observed effects cannot be attributed to the targeted factor without accounting for baseline ``meaning-preserving'' modifications to text that establish general model sensitivity. This is because every counterfactual edit is a compound treatment that bundles the variable of interest with incidental surface-form variation; this violates treatment variation irrelevance. We observe prediction flip rates on MedQA of 14.9% when we surgically change patient gender. However, this is statistically indistinguishable from the flip rates induced by simply paraphrasing inputs (14.1%). In this case, it would therefore be unwarranted to conclude that the LLM is especially sensitive to patient gender. To account for this and robustly measure the effects of targeted interventions, we propose a framework in which we compare (via statistical testing) differences observed under target interventions to those induced by paraphrasing inputs. We then use this framework to revisit a analysis done on the MedPerturb dataset, which reported evidence of model sensitivity to patient demographics and stylistic cues. We find that these effects largely dissipate when we account for general model sensitivity, with only 5 of 120 tests reaching statistical significance. Applying the same framework to occupational biography classification, we detect clearly significant directional gender bias, showing that the framework identifies real directional effects even when they are small. We evaluate a range of metrics -- aggregate, per-sample distributional, and regression -- and find that per-sample metrics are dramatically more powerful than aggregate metrics and regression powerfully and uniquely characterizes effect direction and magnitude.

  • 4 authors
·
Apr 30

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

In recent years, there have been significant breakthroughs in the field of natural language processing, particularly with the development of large language models (LLMs). These LLMs have showcased remarkable capabilities on various benchmarks. In the healthcare field, the exact role LLMs and other future AI models will play remains unclear. There is a potential for these models in the future to be used as part of adaptive physician training, medical co-pilot applications, and digital patient interaction scenarios. The ability of AI models to participate in medical training and patient care will depend in part on their mastery of the knowledge content of specific medical fields. This study investigated the medical knowledge capability of LLMs, specifically in the context of internal medicine subspecialty multiple-choice test-taking ability. We compared the performance of several open-source LLMs (Koala 7B, Falcon 7B, Stable-Vicuna 13B, and Orca Mini 13B), to GPT-4 and Claude 2 on multiple-choice questions in the field of Nephrology. Nephrology was chosen as an example of a particularly conceptually complex subspecialty field within internal medicine. The study was conducted to evaluate the ability of LLM models to provide correct answers to nephSAP (Nephrology Self-Assessment Program) multiple-choice questions. The overall success of open-sourced LLMs in answering the 858 nephSAP multiple-choice questions correctly was 17.1% - 25.5%. In contrast, Claude 2 answered 54.4% of the questions correctly, whereas GPT-4 achieved a score of 73.3%. We show that current widely used open-sourced LLMs do poorly in their ability for zero-shot reasoning when compared to GPT-4 and Claude 2. The findings of this study potentially have significant implications for the future of subspecialty medical training and patient care.

  • 7 authors
·
Aug 9, 2023

Safe, or Simply Incapable? Rethinking Safety Evaluation for Phone-Use Agents

When a phone-use agent avoids harm, does that show safety, or simply inability to act? Existing evaluations often cannot tell. A harmful outcome may be avoided because the agent recognized the risk and chose the safe action, or because it failed to understand the screen or execute any relevant action at all. These cases have different causes and call for different fixes, yet current benchmarks often merge them under task success, refusal, or final harmful outcome. We address this problem with PhoneSafety, a benchmark of 700 safety-critical moments drawn from real phone interactions across more than 130 apps. Each instance isolates the next decision at a risky moment and asks a simple question: does the model take the safe action, take the unsafe action, or fail to do anything useful? We evaluate eight representative phone-use agents under this framework. Our results reveal two main patterns. First, stronger general phone-use ability does not reliably imply safer choices at risky moments. Models that perform better on ordinary app tasks are not always the ones that behave more safely when the next action matters. Second, failures to do anything useful behave like a capability signal rather than a safety signal: they are concentrated in more visually and operationally demanding settings and remain stable when the evaluation protocol changes. Across models, failures split into two recurring patterns: unsafe choices in settings where the model can act but chooses wrongly, and inability to act in more visually and operationally demanding screens. Overall, a harmless outcome is not enough to count as evidence of safety. Evaluating phone-use agents requires separating unsafe judgment from inability to act.

  • 21 authors
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May 7 2

On the Opportunities and Risks of Foundation Models

AI is undergoing a paradigm shift with the rise of models (e.g., BERT, DALL-E, GPT-3) that are trained on broad data at scale and are adaptable to a wide range of downstream tasks. We call these models foundation models to underscore their critically central yet incomplete character. This report provides a thorough account of the opportunities and risks of foundation models, ranging from their capabilities (e.g., language, vision, robotics, reasoning, human interaction) and technical principles(e.g., model architectures, training procedures, data, systems, security, evaluation, theory) to their applications (e.g., law, healthcare, education) and societal impact (e.g., inequity, misuse, economic and environmental impact, legal and ethical considerations). Though foundation models are based on standard deep learning and transfer learning, their scale results in new emergent capabilities,and their effectiveness across so many tasks incentivizes homogenization. Homogenization provides powerful leverage but demands caution, as the defects of the foundation model are inherited by all the adapted models downstream. Despite the impending widespread deployment of foundation models, we currently lack a clear understanding of how they work, when they fail, and what they are even capable of due to their emergent properties. To tackle these questions, we believe much of the critical research on foundation models will require deep interdisciplinary collaboration commensurate with their fundamentally sociotechnical nature.

  • 114 authors
·
Aug 16, 2021