Daily Papers

World models that forecast environmental changes from actions are vital for autonomous driving models with strong generalization. The prevailing driving world model mainly build on video prediction model. Although these models can produce high-fidelity video sequences with advanced diffusion-based generator, they are constrained by their predictive duration and overall generalization capabilities. In this paper, we explore to solve this problem by combining generation loss with MAE-style feature-level context learning. In particular, we instantiate this target with three key design: (1) A more scalable Diffusion Transformer (DiT) structure trained with extra mask construction task. (2) we devise diffusion-related mask tokens to deal with the fuzzy relations between mask reconstruction and generative diffusion process. (3) we extend mask construction task to spatial-temporal domain by utilizing row-wise mask for shifted self-attention rather than masked self-attention in MAE. Then, we adopt a row-wise cross-view module to align with this mask design. Based on above improvement, we propose MaskGWM: a Generalizable driving World Model embodied with Video Mask reconstruction. Our model contains two variants: MaskGWM-long, focusing on long-horizon prediction, and MaskGWM-mview, dedicated to multi-view generation. Comprehensive experiments on standard benchmarks validate the effectiveness of the proposed method, which contain normal validation of Nuscene dataset, long-horizon rollout of OpenDV-2K dataset and zero-shot validation of Waymo dataset. Quantitative metrics on these datasets show our method notably improving state-of-the-art driving world model.

World models can foresee the outcomes of different actions, which is of paramount importance for autonomous driving. Nevertheless, existing driving world models still have limitations in generalization to unseen environments, prediction fidelity of critical details, and action controllability for flexible application. In this paper, we present Vista, a generalizable driving world model with high fidelity and versatile controllability. Based on a systematic diagnosis of existing methods, we introduce several key ingredients to address these limitations. To accurately predict real-world dynamics at high resolution, we propose two novel losses to promote the learning of moving instances and structural information. We also devise an effective latent replacement approach to inject historical frames as priors for coherent long-horizon rollouts. For action controllability, we incorporate a versatile set of controls from high-level intentions (command, goal point) to low-level maneuvers (trajectory, angle, and speed) through an efficient learning strategy. After large-scale training, the capabilities of Vista can seamlessly generalize to different scenarios. Extensive experiments on multiple datasets show that Vista outperforms the most advanced general-purpose video generator in over 70% of comparisons and surpasses the best-performing driving world model by 55% in FID and 27% in FVD. Moreover, for the first time, we utilize the capacity of Vista itself to establish a generalizable reward for real-world action evaluation without accessing the ground truth actions.

Various techniques have been developed in recent years to improve dense retrieval (DR), such as unsupervised contrastive learning and pseudo-query generation. Existing DRs, however, often suffer from effectiveness tradeoffs between supervised and zero-shot retrieval, which some argue was due to the limited model capacity. We contradict this hypothesis and show that a generalizable DR can be trained to achieve high accuracy in both supervised and zero-shot retrieval without increasing model size. In particular, we systematically examine the contrastive learning of DRs, under the framework of Data Augmentation (DA). Our study shows that common DA practices such as query augmentation with generative models and pseudo-relevance label creation using a cross-encoder, are often inefficient and sub-optimal. We hence propose a new DA approach with diverse queries and sources of supervision to progressively train a generalizable DR. As a result, DRAGON, our dense retriever trained with diverse augmentation, is the first BERT-base-sized DR to achieve state-of-the-art effectiveness in both supervised and zero-shot evaluations and even competes with models using more complex late interaction (ColBERTv2 and SPLADE++).

Generating molecules with high binding affinities to target proteins (a.k.a. structure-based drug design) is a fundamental and challenging task in drug discovery. Recently, deep generative models have achieved remarkable success in generating 3D molecules conditioned on the protein pocket. However, most existing methods consider molecular generation for protein pockets independently while neglecting the underlying connections such as subpocket-level similarities. Subpockets are the local protein environments of ligand fragments and pockets with similar subpockets may bind the same molecular fragment (motif) even though their overall structures are different. Therefore, the trained models can hardly generalize to unseen protein pockets in real-world applications. In this paper, we propose a novel method DrugGPS for generalizable structure-based drug design. With the biochemical priors, we propose to learn subpocket prototypes and construct a global interaction graph to model the interactions between subpocket prototypes and molecular motifs. Moreover, a hierarchical graph transformer encoder and motif-based 3D molecule generation scheme are used to improve the model's performance. The experimental results show that our model consistently outperforms baselines in generating realistic drug candidates with high affinities in challenging out-of-distribution settings.

We introduce DragView, a novel and interactive framework for generating novel views of unseen scenes. DragView initializes the new view from a single source image, and the rendering is supported by a sparse set of unposed multi-view images, all seamlessly executed within a single feed-forward pass. Our approach begins with users dragging a source view through a local relative coordinate system. Pixel-aligned features are obtained by projecting the sampled 3D points along the target ray onto the source view. We then incorporate a view-dependent modulation layer to effectively handle occlusion during the projection. Additionally, we broaden the epipolar attention mechanism to encompass all source pixels, facilitating the aggregation of initialized coordinate-aligned point features from other unposed views. Finally, we employ another transformer to decode ray features into final pixel intensities. Crucially, our framework does not rely on either 2D prior models or the explicit estimation of camera poses. During testing, DragView showcases the capability to generalize to new scenes unseen during training, also utilizing only unposed support images, enabling the generation of photo-realistic new views characterized by flexible camera trajectories. In our experiments, we conduct a comprehensive comparison of the performance of DragView with recent scene representation networks operating under pose-free conditions, as well as with generalizable NeRFs subject to noisy test camera poses. DragView consistently demonstrates its superior performance in view synthesis quality, while also being more user-friendly. Project page: https://zhiwenfan.github.io/DragView/.

Expert problem-solving is driven by powerful languages for thinking about problems and their solutions. Acquiring expertise means learning these languages -- systems of concepts, alongside the skills to use them. We present DreamCoder, a system that learns to solve problems by writing programs. It builds expertise by creating programming languages for expressing domain concepts, together with neural networks to guide the search for programs within these languages. A ``wake-sleep'' learning algorithm alternately extends the language with new symbolic abstractions and trains the neural network on imagined and replayed problems. DreamCoder solves both classic inductive programming tasks and creative tasks such as drawing pictures and building scenes. It rediscovers the basics of modern functional programming, vector algebra and classical physics, including Newton's and Coulomb's laws. Concepts are built compositionally from those learned earlier, yielding multi-layered symbolic representations that are interpretable and transferrable to new tasks, while still growing scalably and flexibly with experience.

Today's robot policies exhibit subpar performance when faced with the challenge of generalizing to novel environments. Human corrective feedback is a crucial form of guidance to enable such generalization. However, adapting to and learning from online human corrections is a non-trivial endeavor: not only do robots need to remember human feedback over time to retrieve the right information in new settings and reduce the intervention rate, but also they would need to be able to respond to feedback that can be arbitrary corrections about high-level human preferences to low-level adjustments to skill parameters. In this work, we present Distillation and Retrieval of Online Corrections (DROC), a large language model (LLM)-based system that can respond to arbitrary forms of language feedback, distill generalizable knowledge from corrections, and retrieve relevant past experiences based on textual and visual similarity for improving performance in novel settings. DROC is able to respond to a sequence of online language corrections that address failures in both high-level task plans and low-level skill primitives. We demonstrate that DROC effectively distills the relevant information from the sequence of online corrections in a knowledge base and retrieves that knowledge in settings with new task or object instances. DROC outperforms other techniques that directly generate robot code via LLMs by using only half of the total number of corrections needed in the first round and requires little to no corrections after two iterations. We show further results, videos, prompts and code on https://sites.google.com/stanford.edu/droc .

Large scale 3D scene reconstruction is important for applications such as virtual reality and simulation. Existing neural rendering approaches (e.g., NeRF, 3DGS) have achieved realistic reconstructions on large scenes, but optimize per scene, which is expensive and slow, and exhibit noticeable artifacts under large view changes due to overfitting. Generalizable approaches or large reconstruction models are fast, but primarily work for small scenes/objects and often produce lower quality rendering results. In this work, we introduce G3R, a generalizable reconstruction approach that can efficiently predict high-quality 3D scene representations for large scenes. We propose to learn a reconstruction network that takes the gradient feedback signals from differentiable rendering to iteratively update a 3D scene representation, combining the benefits of high photorealism from per-scene optimization with data-driven priors from fast feed-forward prediction methods. Experiments on urban-driving and drone datasets show that G3R generalizes across diverse large scenes and accelerates the reconstruction process by at least 10x while achieving comparable or better realism compared to 3DGS, and also being more robust to large view changes.

Recent advances in image editing have been driven by the development of denoising diffusion models, marking a significant leap forward in this field. Despite these advances, the generalization capabilities of recent image editing approaches remain constrained. In response to this challenge, our study introduces a novel image editing framework with enhanced generalization robustness by boosting in-context learning capability and unifying language instruction. This framework incorporates a module specifically optimized for image editing tasks, leveraging the VMamba Block and an editing-shift matching strategy to augment in-context learning. Furthermore, we unveil a selective area-matching technique specifically engineered to address and rectify corrupted details in generated images, such as human facial features, to further improve the quality. Another key innovation of our approach is the integration of a language unification technique, which aligns language embeddings with editing semantics to elevate the quality of image editing. Moreover, we compile the first dataset for image editing with visual prompts and editing instructions that could be used to enhance in-context capability. Trained on this dataset, our methodology not only achieves superior synthesis quality for trained tasks, but also demonstrates robust generalization capability across unseen vision tasks through tailored prompts.

Head avatar reconstruction, crucial for applications in virtual reality, online meetings, gaming, and film industries, has garnered substantial attention within the computer vision community. The fundamental objective of this field is to faithfully recreate the head avatar and precisely control expressions and postures. Existing methods, categorized into 2D-based warping, mesh-based, and neural rendering approaches, present challenges in maintaining multi-view consistency, incorporating non-facial information, and generalizing to new identities. In this paper, we propose a framework named GPAvatar that reconstructs 3D head avatars from one or several images in a single forward pass. The key idea of this work is to introduce a dynamic point-based expression field driven by a point cloud to precisely and effectively capture expressions. Furthermore, we use a Multi Tri-planes Attention (MTA) fusion module in the tri-planes canonical field to leverage information from multiple input images. The proposed method achieves faithful identity reconstruction, precise expression control, and multi-view consistency, demonstrating promising results for free-viewpoint rendering and novel view synthesis.

Large, pretrained latent diffusion models (LDMs) have demonstrated an extraordinary ability to generate creative content, specialize to user data through few-shot fine-tuning, and condition their output on other modalities, such as semantic maps. However, are they usable as large-scale data generators, e.g., to improve tasks in the perception stack, like semantic segmentation? We investigate this question in the context of autonomous driving, and answer it with a resounding "yes". We propose an efficient data generation pipeline termed DGInStyle. First, we examine the problem of specializing a pretrained LDM to semantically-controlled generation within a narrow domain. Second, we design a Multi-resolution Latent Fusion technique to overcome the bias of LDMs towards dominant objects. Third, we propose a Style Swap technique to endow the rich generative prior with the learned semantic control. Using DGInStyle, we generate a diverse dataset of street scenes, train a domain-agnostic semantic segmentation model on it, and evaluate the model on multiple popular autonomous driving datasets. Our approach consistently increases the performance of several domain generalization methods, in some cases by +2.5 mIoU compared to the previous state-of-the-art method without our generative augmentation scheme. Source code and dataset are available at https://dginstyle.github.io .

We aim to edit the lip movements in talking video according to the given speech while preserving the personal identity and visual details. The task can be decomposed into two sub-problems: (1) speech-driven lip motion generation and (2) visual appearance synthesis. Current solutions handle the two sub-problems within a single generative model, resulting in a challenging trade-off between lip-sync quality and visual details preservation. Instead, we propose to disentangle the motion and appearance, and then generate them one by one with a speech-to-motion diffusion model and a motion-conditioned appearance generation model. However, there still remain challenges in each stage, such as motion-aware identity preservation in (1) and visual details preservation in (2). Therefore, to preserve personal identity, we adopt landmarks to represent the motion, and further employ a landmark-based identity loss. To capture motion-agnostic visual details, we use separate encoders to encode the lip, non-lip appearance and motion, and then integrate them with a learned fusion module. We train MyTalk on a large-scale and diverse dataset. Experiments show that our method generalizes well to the unknown, even out-of-domain person, in terms of both lip sync and visual detail preservation. We encourage the readers to watch the videos on our project page (https://Ingrid789.github.io/MyTalk/).

Neural Radiance Field (NeRF) has shown impressive performance in novel view synthesis via implicit scene representation. However, it usually suffers from poor scalability as requiring densely sampled images for each new scene. Several studies have attempted to mitigate this problem by integrating Multi-View Stereo (MVS) technique into NeRF while they still entail a cumbersome fine-tuning process for new scenes. Notably, the rendering quality will drop severely without this fine-tuning process and the errors mainly appear around the high-frequency features. In the light of this observation, we design WaveNeRF, which integrates wavelet frequency decomposition into MVS and NeRF to achieve generalizable yet high-quality synthesis without any per-scene optimization. To preserve high-frequency information when generating 3D feature volumes, WaveNeRF builds Multi-View Stereo in the Wavelet domain by integrating the discrete wavelet transform into the classical cascade MVS, which disentangles high-frequency information explicitly. With that, disentangled frequency features can be injected into classic NeRF via a novel hybrid neural renderer to yield faithful high-frequency details, and an intuitive frequency-guided sampling strategy can be designed to suppress artifacts around high-frequency regions. Extensive experiments over three widely studied benchmarks show that WaveNeRF achieves superior generalizable radiance field modeling when only given three images as input.

Recent advancements in 3D reconstruction from single images have been driven by the evolution of generative models. Prominent among these are methods based on Score Distillation Sampling (SDS) and the adaptation of diffusion models in the 3D domain. Despite their progress, these techniques often face limitations due to slow optimization or rendering processes, leading to extensive training and optimization times. In this paper, we introduce a novel approach for single-view reconstruction that efficiently generates a 3D model from a single image via feed-forward inference. Our method utilizes two transformer-based networks, namely a point decoder and a triplane decoder, to reconstruct 3D objects using a hybrid Triplane-Gaussian intermediate representation. This hybrid representation strikes a balance, achieving a faster rendering speed compared to implicit representations while simultaneously delivering superior rendering quality than explicit representations. The point decoder is designed for generating point clouds from single images, offering an explicit representation which is then utilized by the triplane decoder to query Gaussian features for each point. This design choice addresses the challenges associated with directly regressing explicit 3D Gaussian attributes characterized by their non-structural nature. Subsequently, the 3D Gaussians are decoded by an MLP to enable rapid rendering through splatting. Both decoders are built upon a scalable, transformer-based architecture and have been efficiently trained on large-scale 3D datasets. The evaluations conducted on both synthetic datasets and real-world images demonstrate that our method not only achieves higher quality but also ensures a faster runtime in comparison to previous state-of-the-art techniques. Please see our project page at https://zouzx.github.io/TriplaneGaussian/.

Prompt learning for vision-language models, e.g., CoOp, has shown great success in adapting CLIP to different downstream tasks, making it a promising solution for federated learning due to computational reasons. Existing prompt learning techniques replace hand-crafted text prompts with learned vectors that offer improvements on seen classes, but struggle to generalize to unseen classes. Our work addresses this challenge by proposing Federated Text-driven Prompt Generation (FedTPG), which learns a unified prompt generation network across multiple remote clients in a scalable manner. The prompt generation network is conditioned on task-related text input, thus is context-aware, making it suitable to generalize for both seen and unseen classes. Our comprehensive empirical evaluations on nine diverse image classification datasets show that our method is superior to existing federated prompt learning methods, that achieve overall better generalization on both seen and unseen classes and is also generalizable to unseen datasets.

Large language models (LLMs) have demonstrated strong effectiveness and robustness while fine-tuned as dense retrievers. However, their large parameter size brings significant inference time computational challenges, including high encoding costs for large-scale corpora and increased query latency, limiting their practical deployment. While smaller retrievers offer better efficiency, they often fail to generalize effectively with limited supervised fine-tuning data. In this work, we introduce DRAMA, a training framework that leverages LLMs to train smaller generalizable dense retrievers. In particular, we adopt pruned LLMs as the backbone and train on diverse LLM-augmented data in a single-stage contrastive learning setup. Experiments show that DRAMA offers better multilingual and long-context capabilities than traditional encoder-based retrievers, and achieves strong performance across multiple tasks and languages. These highlight the potential of connecting the training of smaller retrievers with the growing advancements in LLMs, bridging the gap between efficiency and generalization.

Transfer learning leverages feature representations of deep neural networks (DNNs) pretrained on source tasks with rich data to empower effective finetuning on downstream tasks. However, the pretrained models are often prohibitively large for delivering generalizable representations, which limits their deployment on edge devices with constrained resources. To close this gap, we propose a new transfer learning pipeline, which leverages our finding that robust tickets can transfer better, i.e., subnetworks drawn with properly induced adversarial robustness can win better transferability over vanilla lottery ticket subnetworks. Extensive experiments and ablation studies validate that our proposed transfer learning pipeline can achieve enhanced accuracy-sparsity trade-offs across both diverse downstream tasks and sparsity patterns, further enriching the lottery ticket hypothesis.

In recent years, wsj0-2mix has become the reference dataset for single-channel speech separation. Most deep learning-based speech separation models today are benchmarked on it. However, recent studies have shown important performance drops when models trained on wsj0-2mix are evaluated on other, similar datasets. To address this generalization issue, we created LibriMix, an open-source alternative to wsj0-2mix, and to its noisy extension, WHAM!. Based on LibriSpeech, LibriMix consists of two- or three-speaker mixtures combined with ambient noise samples from WHAM!. Using Conv-TasNet, we achieve competitive performance on all LibriMix versions. In order to fairly evaluate across datasets, we introduce a third test set based on VCTK for speech and WHAM! for noise. Our experiments show that the generalization error is smaller for models trained with LibriMix than with WHAM!, in both clean and noisy conditions. Aiming towards evaluation in more realistic, conversation-like scenarios, we also release a sparsely overlapping version of LibriMix's test set.

Lifting 2D diffusion for 3D generation is a challenging problem due to the lack of geometric prior and the complex entanglement of materials and lighting in natural images. Existing methods have shown promise by first creating the geometry through score-distillation sampling (SDS) applied to rendered surface normals, followed by appearance modeling. However, relying on a 2D RGB diffusion model to optimize surface normals is suboptimal due to the distribution discrepancy between natural images and normals maps, leading to instability in optimization. In this paper, recognizing that the normal and depth information effectively describe scene geometry and be automatically estimated from images, we propose to learn a generalizable Normal-Depth diffusion model for 3D generation. We achieve this by training on the large-scale LAION dataset together with the generalizable image-to-depth and normal prior models. In an attempt to alleviate the mixed illumination effects in the generated materials, we introduce an albedo diffusion model to impose data-driven constraints on the albedo component. Our experiments show that when integrated into existing text-to-3D pipelines, our models significantly enhance the detail richness, achieving state-of-the-art results. Our project page is https://lingtengqiu.github.io/RichDreamer/.

Crowd Motion Generation is essential in entertainment industries such as animation and games as well as in strategic fields like urban simulation and planning. This new task requires an intricate integration of control and generation to realistically synthesize crowd dynamics under specific spatial and semantic constraints, whose challenges are yet to be fully explored. On the one hand, existing human motion generation models typically focus on individual behaviors, neglecting the complexities of collective behaviors. On the other hand, recent methods for multi-person motion generation depend heavily on pre-defined scenarios and are limited to a fixed, small number of inter-person interactions, thus hampering their practicality. To overcome these challenges, we introduce CrowdMoGen, a zero-shot text-driven framework that harnesses the power of Large Language Model (LLM) to incorporate the collective intelligence into the motion generation framework as guidance, thereby enabling generalizable planning and generation of crowd motions without paired training data. Our framework consists of two key components: 1) Crowd Scene Planner that learns to coordinate motions and dynamics according to specific scene contexts or introduced perturbations, and 2) Collective Motion Generator that efficiently synthesizes the required collective motions based on the holistic plans. Extensive quantitative and qualitative experiments have validated the effectiveness of our framework, which not only fills a critical gap by providing scalable and generalizable solutions for Crowd Motion Generation task but also achieves high levels of realism and flexibility.

This paper introduces a novel paradigm for the generalizable neural radiance field (NeRF). Previous generic NeRF methods combine multiview stereo techniques with image-based neural rendering for generalization, yielding impressive results, while suffering from three issues. First, occlusions often result in inconsistent feature matching. Then, they deliver distortions and artifacts in geometric discontinuities and locally sharp shapes due to their individual process of sampled points and rough feature aggregation. Third, their image-based representations experience severe degradations when source views are not near enough to the target view. To address challenges, we propose the first paradigm that constructs the generalizable neural field based on point-based rather than image-based rendering, which we call the Generalizable neural Point Field (GPF). Our approach explicitly models visibilities by geometric priors and augments them with neural features. We propose a novel nonuniform log sampling strategy to improve both rendering speed and reconstruction quality. Moreover, we present a learnable kernel spatially augmented with features for feature aggregations, mitigating distortions at places with drastically varying geometries. Besides, our representation can be easily manipulated. Experiments show that our model can deliver better geometries, view consistencies, and rendering quality than all counterparts and benchmarks on three datasets in both generalization and finetuning settings, preliminarily proving the potential of the new paradigm for generalizable NeRF.

Recent works in robotic manipulation through reinforcement learning (RL) or imitation learning (IL) have shown potential for tackling a range of tasks e.g., opening a drawer or a cupboard. However, these techniques generalize poorly to unseen objects. We conjecture that this is due to the high-dimensional action space for joint control. In this paper, we take an alternative approach and separate the task of learning 'what to do' from 'how to do it' i.e., whole-body control. We pose the RL problem as one of determining the skill dynamics for a disembodied virtual manipulator interacting with articulated objects. The whole-body robotic kinematic control is optimized to execute the high-dimensional joint motion to reach the goals in the workspace. It does so by solving a quadratic programming (QP) model with robotic singularity and kinematic constraints. Our experiments on manipulating complex articulated objects show that the proposed approach is more generalizable to unseen objects with large intra-class variations, outperforming previous approaches. The evaluation results indicate that our approach generates more compliant robotic motion and outperforms the pure RL and IL baselines in task success rates. Additional information and videos are available at https://kl-research.github.io/decoupskill

The temperature parameter plays a profound role during training and/or inference with large foundation models (LFMs) such as large language models (LLMs) and CLIP models. Particularly, it adjusts the logits in the softmax function in LLMs, which is crucial for next token generation, and it scales the similarities in the contrastive loss for training CLIP models. A significant question remains: Is it viable to learn a neural network to predict a personalized temperature of any input data for enhancing LFMs"? In this paper, we present a principled framework for learning a small yet generalizable temperature prediction network (TempNet) to improve LFMs. Our solution is composed of a novel learning framework with a robust loss underpinned by constrained distributionally robust optimization (DRO), and a properly designed TempNet with theoretical inspiration. TempNet can be trained together with a large foundation model from scratch or learned separately given a pretrained foundation model. It is not only useful for predicting personalized temperature to promote the training of LFMs but also generalizable and transferable to new tasks. Our experiments on LLMs and CLIP models demonstrate that TempNet greatly improves the performance of existing solutions or models, e.g. Table 1. The code to reproduce the experimental results in this paper can be found at https://github.com/zhqiu/TempNet.

Tool-augmented large language models (LLMs) are attracting widespread attention when accessing up-to-date knowledge and alleviating hallucination issues. Nowadays, advanced closed-source LLMs (e.g., ChatGPT) have demonstrated surprising tool-usage capabilities through prompting and in-context learning techniques. To empower the capabilities of open-source LLMs (e.g., LLaMA) in manipulating tools, current efforts focus on either template-driven or token-triggered tool-usage. However, the former hampers LLMs' flexibility to address diverse user's queries due to constrained tool interactions, while the latter limits the generalizability when engaging with new tools, since tool-usage learning is based on task- and tool-specific datasets. To alleviate these concerns, in this paper, we propose a decision-aware and generalizable tool-usage framework (DEER). Specifically, we first construct the tool-usage samples with multiple decision branches via an automatic generation pipeline, thereby inspiring the decision-making awareness of LLMs under diverse scenarios. Meanwhile, we propose a novel tool sampling strategy to enhance the generalizability of LLMs over unseen tools. Extensive experiments demonstrate that our proposed DEER is effective and significantly outperforms baselines across various datasets.

Autoregressive sequence models, such as Transformer-based vision-language action (VLA) policies, can be tremendously effective for capturing complex and generalizable robotic behaviors. However, such models require us to choose a tokenization of our continuous action signals, which determines how the discrete symbols predicted by the model map to continuous robot actions. We find that current approaches for robot action tokenization, based on simple per-dimension, per-timestep binning schemes, typically perform poorly when learning dexterous skills from high-frequency robot data. To address this challenge, we propose a new compression-based tokenization scheme for robot actions, based on the discrete cosine transform. Our tokenization approach, Frequency-space Action Sequence Tokenization (FAST), enables us to train autoregressive VLAs for highly dexterous and high-frequency tasks where standard discretization methods fail completely. Based on FAST, we release FAST+, a universal robot action tokenizer, trained on 1M real robot action trajectories. It can be used as a black-box tokenizer for a wide range of robot action sequences, with diverse action spaces and control frequencies. Finally, we show that, when combined with the pi0 VLA, our method can scale to training on 10k hours of robot data and match the performance of diffusion VLAs, while reducing training time by up to 5x.

In recent years, Large Language Models (LLMs) have achieved almost human-like performance on various tasks. While some LLMs have been trained on multilingual data, most of the training data is in English; hence, their performance in English greatly exceeds other languages. To our knowledge, we are the first to collect and translate a large collection of texts, instructions, and benchmarks and train, evaluate, and release open-source LLMs tailored for Romanian. We evaluate our methods on four different categories, including academic benchmarks, MT-Bench (manually translated), and a professionally built historical, cultural, and social benchmark adapted to Romanian. We argue for the usefulness and high performance of RoLLMs by obtaining state-of-the-art results across the board. We publicly release all resources (i.e., data, training and evaluation code, models) to support and encourage research on Romanian LLMs while concurrently creating a generalizable recipe, adequate for other low or less-resourced languages.

One-shot 3D talking portrait generation aims to reconstruct a 3D avatar from an unseen image, and then animate it with a reference video or audio to generate a talking portrait video. The existing methods fail to simultaneously achieve the goals of accurate 3D avatar reconstruction and stable talking face animation. Besides, while the existing works mainly focus on synthesizing the head part, it is also vital to generate natural torso and background segments to obtain a realistic talking portrait video. To address these limitations, we present Real3D-Potrait, a framework that (1) improves the one-shot 3D reconstruction power with a large image-to-plane model that distills 3D prior knowledge from a 3D face generative model; (2) facilitates accurate motion-conditioned animation with an efficient motion adapter; (3) synthesizes realistic video with natural torso movement and switchable background using a head-torso-background super-resolution model; and (4) supports one-shot audio-driven talking face generation with a generalizable audio-to-motion model. Extensive experiments show that Real3D-Portrait generalizes well to unseen identities and generates more realistic talking portrait videos compared to previous methods. Video samples and source code are available at https://real3dportrait.github.io .

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

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

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Intelligent agents must be generalists - showing the ability to quickly adapt and generalize to varying tasks. Within the framework of reinforcement learning (RL), model-based RL algorithms learn a task-agnostic dynamics model of the world, in principle allowing them to generalize to arbitrary rewards. However, one-step models naturally suffer from compounding errors, making them ineffective for problems with long horizons and large state spaces. In this work, we propose a novel class of models - generalized occupancy models (GOMs) - that retain the generality of model-based RL while avoiding compounding error. The key idea behind GOMs is to model the distribution of all possible long-term outcomes from a given state under the coverage of a stationary dataset, along with a policy that realizes a particular outcome from the given state. These models can then quickly be used to select the optimal action for arbitrary new tasks, without having to redo policy optimization. By directly modeling long-term outcomes, GOMs avoid compounding error while retaining generality across arbitrary reward functions. We provide a practical instantiation of GOMs using diffusion models and show its efficacy as a new class of transferable models, both theoretically and empirically across a variety of simulated robotics problems. Videos and code at https://weirdlabuw.github.io/gom/.

Large Language Models (LLMs) have demonstrated remarkable capabilities across various domains and are moving towards more specialized areas. Recent advanced proprietary models such as GPT-4 and Gemini have achieved significant advancements in biomedicine, which have also raised privacy and security challenges. The construction of specialized generalists hinges largely on high-quality datasets, enhanced by techniques like supervised fine-tuning and reinforcement learning from human or AI feedback, and direct preference optimization. However, these leading technologies (e.g., preference learning) are still significantly limited in the open source community due to the scarcity of specialized data. In this paper, we present the UltraMedical collections, which consist of high-quality manual and synthetic datasets in the biomedicine domain, featuring preference annotations across multiple advanced LLMs. By utilizing these datasets, we fine-tune a suite of specialized medical models based on Llama-3 series, demonstrating breathtaking capabilities across various medical benchmarks. Moreover, we develop powerful reward models skilled in biomedical and general reward benchmark, enhancing further online preference learning within the biomedical LLM community.

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

Building generalizable AI models is one of the primary challenges in the healthcare domain. While radiologists rely on generalizable descriptive rules of abnormality, Neural Network (NN) models suffer even with a slight shift in input distribution (e.g., scanner type). Fine-tuning a model to transfer knowledge from one domain to another requires a significant amount of labeled data in the target domain. In this paper, we develop an interpretable model that can be efficiently fine-tuned to an unseen target domain with minimal computational cost. We assume the interpretable component of NN to be approximately domain-invariant. However, interpretable models typically underperform compared to their Blackbox (BB) variants. We start with a BB in the source domain and distill it into a mixture of shallow interpretable models using human-understandable concepts. As each interpretable model covers a subset of data, a mixture of interpretable models achieves comparable performance as BB. Further, we use the pseudo-labeling technique from semi-supervised learning (SSL) to learn the concept classifier in the target domain, followed by fine-tuning the interpretable models in the target domain. We evaluate our model using a real-life large-scale chest-X-ray (CXR) classification dataset. The code is available at: https://github.com/batmanlab/MICCAI-2023-Route-interpret-repeat-CXRs.

In this paper, we introduce a unified and generalist Biomedical Generative Pre-trained Transformer (BiomedGPT) model, which leverages self-supervision on large and diverse datasets to accept multi-modal inputs and perform a range of downstream tasks. Our experiments demonstrate that BiomedGPT delivers expansive and inclusive representations of biomedical data, outperforming the majority of preceding state-of-the-art models across five distinct tasks with 20 public datasets spanning over 15 unique biomedical modalities. Through the ablation study, we also showcase the efficacy of our multi-modal and multi-task pretraining approach in transferring knowledge to previously unseen data. Overall, our work presents a significant step forward in developing unified and generalist models for biomedicine, with far-reaching implications for improving healthcare outcomes.

The increasing use of tools and solutions based on Large Language Models (LLMs) for various tasks in the medical domain has become a prominent trend. Their use in this highly critical and sensitive domain has thus raised important questions about their robustness, especially in response to variations in input, and the reliability of the generated outputs. This study addresses these questions by constructing a textual dataset based on the ICD-10-CM code descriptions, widely used in US hospitals and containing many clinical terms, and their easily reproducible rephrasing. We then benchmarked existing embedding models, either generalist or specialized in the clinical domain, in a semantic search task where the goal was to correctly match the rephrased text to the original description. Our results showed that generalist models performed better than clinical models, suggesting that existing clinical specialized models are more sensitive to small changes in input that confuse them. The highlighted problem of specialized models may be due to the fact that they have not been trained on sufficient data, and in particular on datasets that are not diverse enough to have a reliable global language understanding, which is still necessary for accurate handling of medical documents.

Domain generalization (DG) is proposed to deal with the issue of domain shift, which occurs when statistical differences exist between source and target domains. However, most current methods do not account for a common realistic scenario where the source and target domains have different classes. To overcome this deficiency, open set domain generalization (OSDG) then emerges as a more practical setting to recognize unseen classes in unseen domains. An intuitive approach is to use multiple one-vs-all classifiers to define decision boundaries for each class and reject the outliers as unknown. However, the significant class imbalance between positive and negative samples often causes the boundaries biased towards positive ones, resulting in misclassification for known samples in the unseen target domain. In this paper, we propose a novel meta-learning-based framework called dualistic MEta-learning with joint DomaIn-Class matching (MEDIC), which considers gradient matching towards inter-domain and inter-class splits simultaneously to find a generalizable boundary balanced for all tasks. Experimental results demonstrate that MEDIC not only outperforms previous methods in open set scenarios, but also maintains competitive close set generalization ability at the same time. Our code is available at https://github.com/zzwdx/MEDIC.

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

The equivalence of realizable and agnostic learnability is a fundamental phenomenon in learning theory. With variants ranging from classical settings like PAC learning and regression to recent trends such as adversarially robust learning, it's surprising that we still lack a unified theory; traditional proofs of the equivalence tend to be disparate, and rely on strong model-specific assumptions like uniform convergence and sample compression. In this work, we give the first model-independent framework explaining the equivalence of realizable and agnostic learnability: a three-line blackbox reduction that simplifies, unifies, and extends our understanding across a wide variety of settings. This includes models with no known characterization of learnability such as learning with arbitrary distributional assumptions and more general loss functions, as well as a host of other popular settings such as robust learning, partial learning, fair learning, and the statistical query model. More generally, we argue that the equivalence of realizable and agnostic learning is actually a special case of a broader phenomenon we call property generalization: any desirable property of a learning algorithm (e.g. noise tolerance, privacy, stability) that can be satisfied over finite hypothesis classes extends (possibly in some variation) to any learnable hypothesis class.

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

Despite recent advancements, most computational methods for molecule optimization are constrained to single- or double-property optimization tasks and suffer from poor scalability and generalizability to novel optimization tasks. Meanwhile, Large Language Models (LLMs) demonstrate remarkable out-of-domain generalizability to novel tasks. To demonstrate LLMs' potential for molecule optimization, we introduce MoMUInstruct, the first high-quality instruction-tuning dataset specifically focused on complex multi-property molecule optimization tasks. Leveraging MoMUInstruct, we develop GeLLM^3Os, a series of instruction-tuned LLMs for molecule optimization. Extensive evaluations across 5 in-domain and 5 out-of-domain tasks demonstrate that GeLLM^3Os consistently outperform state-of-the-art baselines. GeLLM^3Os also exhibit outstanding zero-shot generalization to unseen tasks, significantly outperforming powerful closed-source LLMs. Such strong generalizability demonstrates the tremendous potential of GeLLM^3Os as foundational models for molecule optimization, thereby tackling novel optimization tasks without resource-intensive retraining. MoMUInstruct, models, and code are accessible through https://github.com/ninglab/GeLLMO.

Recent domain generalization (DG) approaches typically use the hypothesis learned on source domains for inference on the unseen target domain. However, such a hypothesis can be arbitrarily far from the optimal one for the target domain, induced by a gap termed ``adaptivity gap''. Without exploiting the domain information from the unseen test samples, adaptivity gap estimation and minimization are intractable, which hinders us to robustify a model to any unknown distribution. In this paper, we first establish a generalization bound that explicitly considers the adaptivity gap. Our bound motivates two strategies to reduce the gap: the first one is ensembling multiple classifiers to enrich the hypothesis space, then we propose effective gap estimation methods for guiding the selection of a better hypothesis for the target. The other method is minimizing the gap directly by adapting model parameters using online target samples. We thus propose Domain-specific Risk Minimization (DRM). During training, DRM models the distributions of different source domains separately; for inference, DRM performs online model steering using the source hypothesis for each arriving target sample. Extensive experiments demonstrate the effectiveness of the proposed DRM for domain generalization with the following advantages: 1) it significantly outperforms competitive baselines on different distributional shift settings; 2) it achieves either comparable or superior accuracies on all source domains compared to vanilla empirical risk minimization; 3) it remains simple and efficient during training, and 4) it is complementary to invariant learning approaches.

To build an artificial neural network like the biological intelligence system, recent works have unified numerous tasks into a generalist model, which can process various tasks with shared parameters and do not have any task-specific modules. While generalist models achieve promising results on various benchmarks, they have performance degradation on some tasks compared with task-specialized models. In this work, we find that interference among different tasks and modalities is the main factor to this phenomenon. To mitigate such interference, we introduce the Conditional Mixture-of-Experts (Conditional MoEs) to generalist models. Routing strategies under different levels of conditions are proposed to take both the training/inference cost and generalization ability into account. By incorporating the proposed Conditional MoEs, the recently proposed generalist model Uni-Perceiver can effectively mitigate the interference across tasks and modalities, and achieves state-of-the-art results on a series of downstream tasks via prompt tuning on 1% of downstream data. Moreover, the introduction of Conditional MoEs still holds the generalization ability of generalist models to conduct zero-shot inference on new tasks, e.g., video-text retrieval and video caption. Code and pre-trained generalist models shall be released.

The generalization mystery in deep learning is the following: Why do over-parameterized neural networks trained with gradient descent (GD) generalize well on real datasets even though they are capable of fitting random datasets of comparable size? Furthermore, from among all solutions that fit the training data, how does GD find one that generalizes well (when such a well-generalizing solution exists)? We argue that the answer to both questions lies in the interaction of the gradients of different examples during training. Intuitively, if the per-example gradients are well-aligned, that is, if they are coherent, then one may expect GD to be (algorithmically) stable, and hence generalize well. We formalize this argument with an easy to compute and interpretable metric for coherence, and show that the metric takes on very different values on real and random datasets for several common vision networks. The theory also explains a number of other phenomena in deep learning, such as why some examples are reliably learned earlier than others, why early stopping works, and why it is possible to learn from noisy labels. Moreover, since the theory provides a causal explanation of how GD finds a well-generalizing solution when one exists, it motivates a class of simple modifications to GD that attenuate memorization and improve generalization. Generalization in deep learning is an extremely broad phenomenon, and therefore, it requires an equally general explanation. We conclude with a survey of alternative lines of attack on this problem, and argue that the proposed approach is the most viable one on this basis.

Recent proprietary large language models (LLMs), such as GPT-4, have achieved a milestone in tackling diverse challenges in the biomedical domain, ranging from multiple-choice questions to long-form generations. To address challenges that still cannot be handled with the encoded knowledge of LLMs, various retrieval-augmented generation (RAG) methods have been developed by searching documents from the knowledge corpus and appending them unconditionally or selectively to the input of LLMs for generation. However, when applying existing methods to different domain-specific problems, poor generalization becomes apparent, leading to fetching incorrect documents or making inaccurate judgments. In this paper, we introduce Self-BioRAG, a framework reliable for biomedical text that specializes in generating explanations, retrieving domain-specific documents, and self-reflecting generated responses. We utilize 84k filtered biomedical instruction sets to train Self-BioRAG that can assess its generated explanations with customized reflective tokens. Our work proves that domain-specific components, such as a retriever, domain-related document corpus, and instruction sets are necessary for adhering to domain-related instructions. Using three major medical question-answering benchmark datasets, experimental results of Self-BioRAG demonstrate significant performance gains by achieving a 7.2% absolute improvement on average over the state-of-the-art open-foundation model with a parameter size of 7B or less. Overall, we analyze that Self-BioRAG finds the clues in the question, retrieves relevant documents if needed, and understands how to answer with information from retrieved documents and encoded knowledge as a medical expert does. We release our data and code for training our framework components and model weights (7B and 13B) to enhance capabilities in biomedical and clinical domains.

Although pre-trained language models have exhibited great flexibility and versatility with prompt-based few-shot learning, they suffer from the extensive parameter size and limited applicability for inference. Recent studies have suggested that PLMs be used as dataset generators and a tiny task-specific model be trained to achieve efficient inference. However, their applicability to various domains is limited because they tend to generate domain-specific datasets. In this work, we propose a novel approach to universal domain generalization that generates a dataset regardless of the target domain. This allows for generalization of the tiny task model to any domain that shares the label space, thus enhancing the real-world applicability of the dataset generation paradigm. Our experiments indicate that the proposed method accomplishes generalizability across various domains while using a parameter set that is orders of magnitude smaller than PLMs.

This paper offers a new perspective to ease the challenge of domain generalization, which involves maintaining robust results even in unseen environments. Our design focuses on the decision-making process in the final classifier layer. Specifically, we propose treating the element-wise contributions to the final results as the rationale for making a decision and representing the rationale for each sample as a matrix. For a well-generalized model, we suggest the rationale matrices for samples belonging to the same category should be similar, indicating the model relies on domain-invariant clues to make decisions, thereby ensuring robust results. To implement this idea, we introduce a rationale invariance loss as a simple regularization technique, requiring only a few lines of code. Our experiments demonstrate that the proposed approach achieves competitive results across various datasets, despite its simplicity. Code is available at https://github.com/liangchen527/RIDG.

Domain generalization (DG) aims to avoid the performance degradation of the model when the distribution shift between the limited training data and unseen test data occurs. Recently, foundation models with enormous parameters have been pre-trained with huge datasets, demonstrating strong generalization ability and showing promising direction for solving the DG problem. However, fully Fine-Tuning (FT) the foundation models results in unsatisfactory out-of-distribution accuracy due to the destroyed pre-trained generalized features. Recently, Parameter-Efficient Fine-Tuning (PEFT) alleviates the above problem by fine-tuning a small portion of the model parameters while keeping the rest frozen, which achieves better generalization performance compared to FT. Nevertheless, PEFT still suffers from the issue of overfitting to the training domains. To address the above issue, we propose Parameter-Efficient Group with Orthogonal regularization (PEGO) for vision transformers, which effectively preserves the generalization ability of the pre-trained network and learns more diverse knowledge compared with conventional PEFT. Specifically, we inject a group of trainable Low-Rank Adaptation (LoRA) modules into the pre-trained model and propose an orthogonal regularization loss to enhance the generalization ability of the model. Our framework achieves SOTA performance on five DG benchmarks, while only requiring training a small number of parameters without adding additional testing cost.

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

People increasingly search online for answers to their medical questions but the rate at which medical questions are asked online significantly exceeds the capacity of qualified people to answer them. This leaves many questions unanswered or inadequately answered. Many of these questions are not unique, and reliable identification of similar questions would enable more efficient and effective question answering schema. COVID-19 has only exacerbated this problem. Almost every government agency and healthcare organization has tried to meet the informational need of users by building online FAQs, but there is no way for people to ask their question and know if it is answered on one of these pages. While many research efforts have focused on the problem of general question similarity, these approaches do not generalize well to domains that require expert knowledge to determine semantic similarity, such as the medical domain. In this paper, we show how a double fine-tuning approach of pretraining a neural network on medical question-answer pairs followed by fine-tuning on medical question-question pairs is a particularly useful intermediate task for the ultimate goal of determining medical question similarity. While other pretraining tasks yield an accuracy below 78.7% on this task, our model achieves an accuracy of 82.6% with the same number of training examples, an accuracy of 80.0% with a much smaller training set, and an accuracy of 84.5% when the full corpus of medical question-answer data is used. We also describe a currently live system that uses the trained model to match user questions to COVID-related FAQs.

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

Recent diagnostic datasets on compositional generalization, such as SCAN (Lake and Baroni, 2018) and COGS (Kim and Linzen, 2020), expose severe problems in models trained from scratch on these datasets. However, in contrast to this poor performance, state-of-the-art models trained on larger and more general datasets show better generalization ability. In this work, to reconcile this inconsistency, we conduct an empirical analysis by training Transformer models on a variety of training sets with different data factors, including dataset scale, pattern complexity, example difficulty, etc. First, we show that increased dataset complexity can lead to better generalization behavior on multiple different generalization challenges. To further understand this improvement, we show two axes of the benefit from more complex datasets: they provide more diverse examples so compositional understanding becomes more effective, and they also prevent ungeneralizable memorization of the examples due to reduced example repetition frequency. Finally, we explore how training examples of different difficulty levels influence generalization differently. On synthetic datasets, simple examples invoke stronger compositionality than hard examples do. On larger-scale real language datasets, while hard examples become more important potentially to ensure decent data coverage, a balanced mixture of simple and hard examples manages to induce the strongest generalizability. The code and data for this work are available at https://github.com/owenzx/data4comp

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

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

We introduce Domain-specific Masks for Generalization, a model for improving both in-domain and out-of-domain generalization performance. For domain generalization, the goal is to learn from a set of source domains to produce a single model that will best generalize to an unseen target domain. As such, many prior approaches focus on learning representations which persist across all source domains with the assumption that these domain agnostic representations will generalize well. However, often individual domains contain characteristics which are unique and when leveraged can significantly aid in-domain recognition performance. To produce a model which best generalizes to both seen and unseen domains, we propose learning domain specific masks. The masks are encouraged to learn a balance of domain-invariant and domain-specific features, thus enabling a model which can benefit from the predictive power of specialized features while retaining the universal applicability of domain-invariant features. We demonstrate competitive performance compared to naive baselines and state-of-the-art methods on both PACS and DomainNet.

Large language models (LLM) have achieved impressive performance on medical question-answering benchmarks. However, high benchmark accuracy does not imply that the performance generalizes to real-world clinical settings. Medical question-answering benchmarks rely on assumptions consistent with quantifying LLM performance but that may not hold in the open world of the clinic. Yet LLMs learn broad knowledge that can help the LLM generalize to practical conditions regardless of unrealistic assumptions in celebrated benchmarks. We seek to quantify how well LLM medical question-answering benchmark performance generalizes when benchmark assumptions are violated. Specifically, we present an adversarial method that we call MedFuzz (for medical fuzzing). MedFuzz attempts to modify benchmark questions in ways aimed at confounding the LLM. We demonstrate the approach by targeting strong assumptions about patient characteristics presented in the MedQA benchmark. Successful "attacks" modify a benchmark item in ways that would be unlikely to fool a medical expert but nonetheless "trick" the LLM into changing from a correct to an incorrect answer. Further, we present a permutation test technique that can ensure a successful attack is statistically significant. We show how to use performance on a "MedFuzzed" benchmark, as well as individual successful attacks. The methods show promise at providing insights into the ability of an LLM to operate robustly in more realistic settings.

The measure of a machine learning algorithm is the difficulty of the tasks it can perform, and sufficiently difficult tasks are critical drivers of strong machine learning models. However, quantifying the generalization difficulty of machine learning benchmarks has remained challenging. We propose what is to our knowledge the first model-agnostic measure of the inherent generalization difficulty of tasks. Our inductive bias complexity measure quantifies the total information required to generalize well on a task minus the information provided by the data. It does so by measuring the fractional volume occupied by hypotheses that generalize on a task given that they fit the training data. It scales exponentially with the intrinsic dimensionality of the space over which the model must generalize but only polynomially in resolution per dimension, showing that tasks which require generalizing over many dimensions are drastically more difficult than tasks involving more detail in fewer dimensions. Our measure can be applied to compute and compare supervised learning, reinforcement learning and meta-learning generalization difficulties against each other. We show that applied empirically, it formally quantifies intuitively expected trends, e.g. that in terms of required inductive bias, MNIST < CIFAR10 < Imagenet and fully observable Markov decision processes (MDPs) < partially observable MDPs. Further, we show that classification of complex images < few-shot meta-learning with simple images. Our measure provides a quantitative metric to guide the construction of more complex tasks requiring greater inductive bias, and thereby encourages the development of more sophisticated architectures and learning algorithms with more powerful generalization capabilities.

Model selection/optimization in conformal inference is challenging, since it may break the exchangeability between labeled and unlabeled data. We study this problem in the context of conformal selection, which uses conformal p-values to select ``interesting'' instances with large unobserved labels from a pool of unlabeled data, while controlling the FDR in finite sample. For validity, existing solutions require the model choice to be independent of the data used to construct the p-values and calibrate the selection set. However, when presented with many model choices and limited labeled data, it is desirable to (i) select the best model in a data-driven manner, and (ii) mitigate power loss due to sample splitting. This paper presents OptCS, a general framework that allows valid statistical testing (selection) after flexible data-driven model optimization. We introduce general conditions under which OptCS constructs valid conformal p-values despite substantial data reuse and handles complex p-value dependencies to maintain finite-sample FDR control via a novel multiple testing procedure. We instantiate this general recipe to propose three FDR-controlling procedures, each optimizing the models differently: (i) selecting the most powerful one among multiple pre-trained candidate models, (ii) using all data for model fitting without sample splitting, and (iii) combining full-sample model fitting and selection. We demonstrate the efficacy of our methods via simulation studies and real applications in drug discovery and alignment of large language models in radiology report generation.

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

Existing person re-identification models often have low generalizability, which is mostly due to limited availability of large-scale labeled data in training. However, labeling large-scale training data is very expensive and time-consuming, while large-scale synthetic dataset shows promising value in learning generalizable person re-identification models. Therefore, in this paper a novel and practical person re-identification task is proposed,i.e. how to use labeled synthetic dataset and unlabeled real-world dataset to train a universal model. In this way, human annotations are no longer required, and it is scalable to large and diverse real-world datasets. To address the task, we introduce a framework with high generalizability, namely DomainMix. Specifically, the proposed method firstly clusters the unlabeled real-world images and selects the reliable clusters. During training, to address the large domain gap between two domains, a domain-invariant feature learning method is proposed, which introduces a new loss,i.e. domain balance loss, to conduct an adversarial learning between domain-invariant feature learning and domain discrimination, and meanwhile learns a discriminative feature for person re-identification. This way, the domain gap between synthetic and real-world data is much reduced, and the learned feature is generalizable thanks to the large-scale and diverse training data. Experimental results show that the proposed annotation-free method is more or less comparable to the counterpart trained with full human annotations, which is quite promising. In addition, it achieves the current state of the art on several person re-identification datasets under direct cross-dataset evaluation.

Recently, large language model (LLM) based artificial intelligence (AI) systems have demonstrated remarkable capabilities in natural language understanding and generation. However, these models face a significant challenge when it comes to sensitive applications, such as reasoning over medical knowledge and answering medical questions in a physician-like manner. Prior studies attempted to overcome this challenge by increasing the model size (>100B) to learn more general medical knowledge, while there is still room for improvement in LLMs with smaller-scale model sizes (<100B). In this work, we start from a pre-trained general LLM model (AntGLM-10B) and fine-tune it from a medical beginner towards a medical expert (called AntGLM-Med-10B), which leverages a 3-stage optimization procedure, i.e., general medical knowledge injection, medical domain instruction tuning, and specific medical task adaptation. Our contributions are threefold: (1) We specifically investigate how to adapt a pre-trained general LLM in medical domain, especially for a specific medical task. (2) We collect and construct large-scale medical datasets for each stage of the optimization process. These datasets encompass various data types and tasks, such as question-answering, medical reasoning, multi-choice questions, and medical conversations. (3) Specifically for multi-choice questions in the medical domain, we propose a novel Verification-of-Choice approach for prompting engineering, which significantly enhances the reasoning ability of LLMs. Remarkably, by combining the above approaches, our AntGLM-Med-10B model can outperform the most of LLMs on PubMedQA, including both general and medical LLMs, even when these LLMs have larger model size.

The potential of large language models (LLMs) to simultaneously perform a wide range of natural language processing (NLP) tasks has been the subject of extensive research. Although instruction tuning has proven to be a data-efficient method for transforming LLMs into such generalist models, their performance still lags behind specialist models trained exclusively for specific tasks. In this paper, we investigate whether incorporating broad-coverage generalist instruction tuning can contribute to building a specialist model. We hypothesize that its efficacy depends on task specificity and skill requirements. Our experiments assess four target tasks with distinct coverage levels, revealing that integrating generalist instruction tuning consistently enhances model performance when the task coverage is broad. The effect is particularly pronounced when the amount of task-specific training data is limited. Further investigation into three target tasks focusing on different capabilities demonstrates that generalist instruction tuning improves understanding and reasoning abilities. However, for tasks requiring factual knowledge, generalist data containing hallucinatory information may negatively affect the model's performance. Overall, our work provides a systematic guide for developing specialist models with general instruction tuning. Our code and other related resources can be found at https://github.com/DavidFanzz/Generalist_or_Specialist.

Keeping track of scientific challenges, advances and emerging directions is a fundamental part of research. However, researchers face a flood of papers that hinders discovery of important knowledge. In biomedicine, this directly impacts human lives. To address this problem, we present a novel task of extraction and search of scientific challenges and directions, to facilitate rapid knowledge discovery. We construct and release an expert-annotated corpus of texts sampled from full-length papers, labeled with novel semantic categories that generalize across many types of challenges and directions. We focus on a large corpus of interdisciplinary work relating to the COVID-19 pandemic, ranging from biomedicine to areas such as AI and economics. We apply a model trained on our data to identify challenges and directions across the corpus and build a dedicated search engine. In experiments with 19 researchers and clinicians using our system, we outperform a popular scientific search engine in assisting knowledge discovery. Finally, we show that models trained on our resource generalize to the wider biomedical domain and to AI papers, highlighting its broad utility. We make our data, model and search engine publicly available. https://challenges.apps.allenai.org/

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

Databases of electronic health records (EHRs) are increasingly used to inform clinical decisions. Machine learning methods can find patterns in EHRs that are predictive of future adverse outcomes. However, statistical models may be built upon patterns of health-seeking behavior that vary across patient subpopulations, leading to poor predictive performance when training on one patient population and predicting on another. This note proposes two tests to better measure and understand model generalization. We use these tests to compare models derived from two data sources: (i) historical medical records, and (ii) electrocardiogram (EKG) waveforms. In a predictive task, we show that EKG-based models can be more stable than EHR-based models across different patient populations.

While deep learning models have become the predominant method for medical image segmentation, they are typically not capable of generalizing to unseen segmentation tasks involving new anatomies, image modalities, or labels. Given a new segmentation task, researchers generally have to train or fine-tune models, which is time-consuming and poses a substantial barrier for clinical researchers, who often lack the resources and expertise to train neural networks. We present UniverSeg, a method for solving unseen medical segmentation tasks without additional training. Given a query image and example set of image-label pairs that define a new segmentation task, UniverSeg employs a new Cross-Block mechanism to produce accurate segmentation maps without the need for additional training. To achieve generalization to new tasks, we have gathered and standardized a collection of 53 open-access medical segmentation datasets with over 22,000 scans, which we refer to as MegaMedical. We used this collection to train UniverSeg on a diverse set of anatomies and imaging modalities. We demonstrate that UniverSeg substantially outperforms several related methods on unseen tasks, and thoroughly analyze and draw insights about important aspects of the proposed system. The UniverSeg source code and model weights are freely available at https://universeg.csail.mit.edu

The medical domain is vast and diverse, with many existing embedding models focused on general healthcare applications. However, these models often struggle to capture a deep understanding of diseases due to their broad generalization across the entire medical field. To address this gap, I present DisEmbed, a disease-focused embedding model. DisEmbed is trained on a synthetic dataset specifically curated to include disease descriptions, symptoms, and disease-related Q\&A pairs, making it uniquely suited for disease-related tasks. For evaluation, I benchmarked DisEmbed against existing medical models using disease-specific datasets and the triplet evaluation method. My results demonstrate that DisEmbed outperforms other models, particularly in identifying disease-related contexts and distinguishing between similar diseases. This makes DisEmbed highly valuable for disease-specific use cases, including retrieval-augmented generation (RAG) tasks, where its performance is particularly robust.

In machine learning, generative modeling aims to learn to generate new data statistically similar to the training data distribution. In this paper, we survey learning generative models under limited data, few shots and zero shot, referred to as Generative Modeling under Data Constraint (GM-DC). This is an important topic when data acquisition is challenging, e.g. healthcare applications. We discuss background, challenges, and propose two taxonomies: one on GM-DC tasks and another on GM-DC approaches. Importantly, we study interactions between different GM-DC tasks and approaches. Furthermore, we highlight research gaps, research trends, and potential avenues for future exploration. Project website: https://gmdc-survey.github.io.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

For text-based AI systems to interact in the real world, causal reasoning is an essential skill. Since interventional data is costly to generate, we study to what extent an agent can learn causal reasoning from passive data. Specifically, we consider an axiomatic training setup where an agent learns from multiple demonstrations of a causal axiom (or rule), rather than incorporating the axiom as an inductive bias or inferring it from data values. A key question is whether the agent would learn to generalize from the axiom demonstrations to new scenarios. For example, if a transformer model is trained on demonstrations of the causal transitivity axiom over small graphs, would it generalize to applying the transitivity axiom over large graphs? Our results, based on a novel axiomatic training scheme, indicate that such generalization is possible. We consider the task of inferring whether a variable causes another variable, given a causal graph structure. We find that a 67 million parameter transformer model, when trained on linear causal chains (along with some noisy variations) can generalize well to new kinds of graphs, including longer causal chains, causal chains with reversed order, and graphs with branching; even when it is not explicitly trained for such settings. Our model performs at par (or even better) than many larger language models such as GPT-4, Gemini Pro, and Phi-3. Overall, our axiomatic training framework provides a new paradigm of learning causal reasoning from passive data that can be used to learn arbitrary axioms, as long as sufficient demonstrations can be generated.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

Med42-v2 introduces a suite of clinical large language models (LLMs) designed to address the limitations of generic models in healthcare settings. These models are built on Llama3 architecture and fine-tuned using specialized clinical data. They underwent multi-stage preference alignment to effectively respond to natural prompts. While generic models are often preference-aligned to avoid answering clinical queries as a precaution, Med42-v2 is specifically trained to overcome this limitation, enabling its use in clinical settings. Med42-v2 models demonstrate superior performance compared to the original Llama3 models in both 8B and 70B parameter configurations and GPT-4 across various medical benchmarks. These LLMs are developed to understand clinical queries, perform reasoning tasks, and provide valuable assistance in clinical environments. The models are now publicly available at https://huggingface.co/m42-health{https://huggingface.co/m42-health}.

OpenAI's Sora highlights the potential of video generation for developing world models that adhere to fundamental physical laws. However, the ability of video generation models to discover such laws purely from visual data without human priors can be questioned. A world model learning the true law should give predictions robust to nuances and correctly extrapolate on unseen scenarios. In this work, we evaluate across three key scenarios: in-distribution, out-of-distribution, and combinatorial generalization. We developed a 2D simulation testbed for object movement and collisions to generate videos deterministically governed by one or more classical mechanics laws. This provides an unlimited supply of data for large-scale experimentation and enables quantitative evaluation of whether the generated videos adhere to physical laws. We trained diffusion-based video generation models to predict object movements based on initial frames. Our scaling experiments show perfect generalization within the distribution, measurable scaling behavior for combinatorial generalization, but failure in out-of-distribution scenarios. Further experiments reveal two key insights about the generalization mechanisms of these models: (1) the models fail to abstract general physical rules and instead exhibit "case-based" generalization behavior, i.e., mimicking the closest training example; (2) when generalizing to new cases, models are observed to prioritize different factors when referencing training data: color > size > velocity > shape. Our study suggests that scaling alone is insufficient for video generation models to uncover fundamental physical laws, despite its role in Sora's broader success. See our project page at https://phyworld.github.io

The rapid progress in Large Language Models (LLMs) has prompted the creation of numerous benchmarks to evaluate their capabilities.This study focuses on the Comprehensive Medical Benchmark in Chinese (CMB), showcasing how dataset diversity and distribution in supervised fine-tuning (SFT) may enhance LLM performance.Remarkably, We successfully trained a smaller base model to achieve scores comparable to larger models, indicating that a diverse and well-distributed dataset can optimize performance regardless of model size.This study suggests that even smaller models may reach high performance levels with carefully curated and varied datasets.By integrating a wide range of instructional content, our approach addresses potential issues such as data quality inconsistencies. Our results imply that a broader spectrum of training data may enhance a model's ability to generalize and perform effectively across different medical scenarios, highlighting the importance of dataset quality and diversity in fine-tuning processes.

The rapid evolution of Large Language Models (LLMs) offers promising potential to alleviate the global scarcity of mental health professionals. However, LLMs' alignment with essential mental health counseling competencies remains understudied. We introduce CounselingBench, a novel NCMHCE-based benchmark evaluating LLMs across five key mental health counseling competencies. Testing 22 general-purpose and medical-finetuned LLMs, we find frontier models exceed minimum thresholds but fall short of expert-level performance, with significant variations: they excel in Intake, Assessment & Diagnosis yet struggle with Core Counseling Attributes and Professional Practice & Ethics. Medical LLMs surprisingly underperform generalist models accuracy-wise, while at the same time producing slightly higher-quality justifications but making more context-related errors. Our findings highlight the complexities of developing AI systems for mental health counseling, particularly for competencies requiring empathy and contextual understanding. We found that frontier LLMs perform at a level exceeding the minimal required level of aptitude for all key mental health counseling competencies, but fall short of expert-level performance, and that current medical LLMs do not significantly improve upon generalist models in mental health counseling competencies. This underscores the critical need for specialized, mental health counseling-specific fine-tuned LLMs that rigorously aligns with core competencies combined with appropriate human supervision before any responsible real-world deployment can be considered.

Deep neural networks often rely on spurious correlations to make predictions, which hinders generalization beyond training environments. For instance, models that associate cats with bed backgrounds can fail to predict the existence of cats in other environments without beds. Mitigating spurious correlations is crucial in building trustworthy models. However, the existing works lack transparency to offer insights into the mitigation process. In this work, we propose an interpretable framework, Discover and Cure (DISC), to tackle the issue. With human-interpretable concepts, DISC iteratively 1) discovers unstable concepts across different environments as spurious attributes, then 2) intervenes on the training data using the discovered concepts to reduce spurious correlation. Across systematic experiments, DISC provides superior generalization ability and interpretability than the existing approaches. Specifically, it outperforms the state-of-the-art methods on an object recognition task and a skin-lesion classification task by 7.5% and 9.6%, respectively. Additionally, we offer theoretical analysis and guarantees to understand the benefits of models trained by DISC. Code and data are available at https://github.com/Wuyxin/DISC.

In hematology, computational models offer significant potential to improve diagnostic accuracy, streamline workflows, and reduce the tedious work of analyzing single cells in peripheral blood or bone marrow smears. However, clinical adoption of computational models has been hampered by the lack of generalization due to large batch effects, small dataset sizes, and poor performance in transfer learning from natural images. To address these challenges, we introduce DinoBloom, the first foundation model for single cell images in hematology, utilizing a tailored DINOv2 pipeline. Our model is built upon an extensive collection of 13 diverse, publicly available datasets of peripheral blood and bone marrow smears, the most substantial open-source cohort in hematology so far, comprising over 380,000 white blood cell images. To assess its generalization capability, we evaluate it on an external dataset with a challenging domain shift. We show that our model outperforms existing medical and non-medical vision models in (i) linear probing and k-nearest neighbor evaluations for cell-type classification on blood and bone marrow smears and (ii) weakly supervised multiple instance learning for acute myeloid leukemia subtyping by a large margin. A family of four DinoBloom models (small, base, large, and giant) can be adapted for a wide range of downstream applications, be a strong baseline for classification problems, and facilitate the assessment of batch effects in new datasets. All models are available at github.com/marrlab/DinoBloom.

One method for obtaining generalizable solutions to machine learning tasks when presented with diverse training environments is to find invariant representations of the data. These are representations of the covariates such that the best model on top of the representation is invariant across training environments. In the context of linear Structural Equation Models (SEMs), invariant representations might allow us to learn models with out-of-distribution guarantees, i.e., models that are robust to interventions in the SEM. To address the invariant representation problem in a {\em finite sample} setting, we consider the notion of epsilon-approximate invariance. We study the following question: If a representation is approximately invariant with respect to a given number of training interventions, will it continue to be approximately invariant on a larger collection of unseen SEMs? This larger collection of SEMs is generated through a parameterized family of interventions. Inspired by PAC learning, we obtain finite-sample out-of-distribution generalization guarantees for approximate invariance that holds probabilistically over a family of linear SEMs without faithfulness assumptions. Our results show bounds that do not scale in ambient dimension when intervention sites are restricted to lie in a constant size subset of in-degree bounded nodes. We also show how to extend our results to a linear indirect observation model that incorporates latent variables.

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

In this work, we introduce Multiple Embedding Model for EHR (MEME), an approach that views Electronic Health Records (EHR) as multimodal data. This approach incorporates "pseudo-notes", textual representations of tabular EHR concepts such as diagnoses and medications, and allows us to effectively employ Large Language Models (LLMs) for EHR representation. This framework also adopts a multimodal approach, embedding each EHR modality separately. We demonstrate the effectiveness of MEME by applying it to several tasks within the Emergency Department across multiple hospital systems. Our findings show that MEME surpasses the performance of both single modality embedding methods and traditional machine learning approaches. However, we also observe notable limitations in generalizability across hospital institutions for all tested models.

The digitization of healthcare has facilitated the sharing and re-using of medical data but has also raised concerns about confidentiality and privacy. HIPAA (Health Insurance Portability and Accountability Act) mandates removing re-identifying information before the dissemination of medical records. Thus, effective and efficient solutions for de-identifying medical data, especially those in free-text forms, are highly needed. While various computer-assisted de-identification methods, including both rule-based and learning-based, have been developed and used in prior practice, such solutions still lack generalizability or need to be fine-tuned according to different scenarios, significantly imposing restrictions in wider use. The advancement of large language models (LLM), such as ChatGPT and GPT-4, have shown great potential in processing text data in the medical domain with zero-shot in-context learning, especially in the task of privacy protection, as these models can identify confidential information by their powerful named entity recognition (NER) capability. In this work, we developed a novel GPT4-enabled de-identification framework (``DeID-GPT") to automatically identify and remove the identifying information. Compared to existing commonly used medical text data de-identification methods, our developed DeID-GPT showed the highest accuracy and remarkable reliability in masking private information from the unstructured medical text while preserving the original structure and meaning of the text. This study is one of the earliest to utilize ChatGPT and GPT-4 for medical text data processing and de-identification, which provides insights for further research and solution development on the use of LLMs such as ChatGPT/GPT-4 in healthcare. Codes and benchmarking data information are available at https://github.com/yhydhx/ChatGPT-API.

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

Generalist vision language models (VLMs) have made significant strides in computer vision, but they fall short in specialized fields like healthcare, where expert knowledge is essential. In traditional computer vision tasks, creative or approximate answers may be acceptable, but in healthcare, precision is paramount.Current large multimodal models like Gemini and GPT-4o are insufficient for medical tasks due to their reliance on memorized internet knowledge rather than the nuanced expertise required in healthcare. VLMs are usually trained in three stages: vision pre-training, vision-language pre-training, and instruction fine-tuning (IFT). IFT has been typically applied using a mixture of generic and healthcare data. In contrast, we propose that for medical VLMs, a fourth stage of specialized IFT is necessary, which focuses on medical data and includes information from domain expert models. Domain expert models developed for medical use are crucial because they are specifically trained for certain clinical tasks, e.g. to detect tumors and classify abnormalities through segmentation and classification, which learn fine-grained features of medical data-features that are often too intricate for a VLM to capture effectively especially in radiology. This paper introduces a new framework, VILA-M3, for medical VLMs that utilizes domain knowledge via expert models. Through our experiments, we show an improved state-of-the-art (SOTA) performance with an average improvement of ~9% over the prior SOTA model Med-Gemini and ~6% over models trained on the specific tasks. Our approach emphasizes the importance of domain expertise in creating precise, reliable VLMs for medical applications.

Large language models, particularly GPT-3, are able to produce high quality summaries of general domain news articles in few- and zero-shot settings. However, it is unclear if such models are similarly capable in more specialized, high-stakes domains such as biomedicine. In this paper, we enlist domain experts (individuals with medical training) to evaluate summaries of biomedical articles generated by GPT-3, given zero supervision. We consider both single- and multi-document settings. In the former, GPT-3 is tasked with generating regular and plain-language summaries of articles describing randomized controlled trials; in the latter, we assess the degree to which GPT-3 is able to synthesize evidence reported across a collection of articles. We design an annotation scheme for evaluating model outputs, with an emphasis on assessing the factual accuracy of generated summaries. We find that while GPT-3 is able to summarize and simplify single biomedical articles faithfully, it struggles to provide accurate aggregations of findings over multiple documents. We release all data and annotations used in this work.

In machine learning, generalization against distribution shifts -- where deployment conditions diverge from the training scenarios -- is crucial, particularly in fields like climate modeling, biomedicine, and autonomous driving. The emergence of foundation models, distinguished by their extensive pretraining and task versatility, has led to an increased interest in their adaptability to distribution shifts. GPT-4V(ision) acts as the most advanced publicly accessible multimodal foundation model, with extensive applications across various domains, including anomaly detection, video understanding, image generation, and medical diagnosis. However, its robustness against data distributions remains largely underexplored. Addressing this gap, this study rigorously evaluates GPT-4V's adaptability and generalization capabilities in dynamic environments, benchmarking against prominent models like CLIP and LLaVA. We delve into GPT-4V's zero-shot generalization across 13 diverse datasets spanning natural, medical, and molecular domains. We further investigate its adaptability to controlled data perturbations and examine the efficacy of in-context learning as a tool to enhance its adaptation. Our findings delineate GPT-4V's capability boundaries in distribution shifts, shedding light on its strengths and limitations across various scenarios. Importantly, this investigation contributes to our understanding of how AI foundation models generalize to distribution shifts, offering pivotal insights into their adaptability and robustness. Code is publicly available at https://github.com/jameszhou-gl/gpt-4v-distribution-shift.

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

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

Supervised learning datasets may contain multiple cues that explain the training set equally well, i.e., learning any of them would lead to the correct predictions on the training data. However, many of them can be spurious, i.e., lose their predictive power under a distribution shift and consequently fail to generalize to out-of-distribution (OOD) data. Recently developed "diversification" methods (Lee et al., 2023; Pagliardini et al., 2023) approach this problem by finding multiple diverse hypotheses that rely on different features. This paper aims to study this class of methods and identify the key components contributing to their OOD generalization abilities. We show that (1) diversification methods are highly sensitive to the distribution of the unlabeled data used for diversification and can underperform significantly when away from a method-specific sweet spot. (2) Diversification alone is insufficient for OOD generalization. The choice of the used learning algorithm, e.g., the model's architecture and pretraining, is crucial. In standard experiments (classification on Waterbirds and Office-Home datasets), using the second-best choice leads to an up to 20\% absolute drop in accuracy. (3) The optimal choice of learning algorithm depends on the unlabeled data and vice versa i.e. they are co-dependent. (4) Finally, we show that, in practice, the above pitfalls cannot be alleviated by increasing the number of diverse hypotheses, the major feature of diversification methods. These findings provide a clearer understanding of the critical design factors influencing the OOD generalization abilities of diversification methods. They can guide practitioners in how to use the existing methods best and guide researchers in developing new, better ones.

Generalized Category Discovery (GCD) aims to discover novel categories in unlabelled datasets using knowledge learned from labelled samples. Previous studies argued that parametric classifiers are prone to overfitting to seen categories, and endorsed using a non-parametric classifier formed with semi-supervised k-means. However, in this study, we investigate the failure of parametric classifiers, verify the effectiveness of previous design choices when high-quality supervision is available, and identify unreliable pseudo-labels as a key problem. We demonstrate that two prediction biases exist: the classifier tends to predict seen classes more often, and produces an imbalanced distribution across seen and novel categories. Based on these findings, we propose a simple yet effective parametric classification method that benefits from entropy regularisation, achieves state-of-the-art performance on multiple GCD benchmarks and shows strong robustness to unknown class numbers. We hope the investigation and proposed simple framework can serve as a strong baseline to facilitate future studies in this field. Our code is available at: https://github.com/CVMI-Lab/SimGCD.

The sparsity of labelled data is an obstacle to the development of Relation Extraction models and the completion of databases in various biomedical areas. While being of high interest in drug-discovery, the natural-products literature, reporting the identification of potential bioactive compounds from organisms, is a concrete example of such an overlooked topic. To mark the start of this new task, we created the first curated evaluation dataset and extracted literature items from the LOTUS database to build training sets. To this end, we developed a new sampler inspired by diversity metrics in ecology, named Greedy Maximum Entropy sampler, or GME-sampler (https://github.com/idiap/gme-sampler). The strategic optimization of both balance and diversity of the selected items in the evaluation set is important given the resource-intensive nature of manual curation. After quantifying the noise in the training set, in the form of discrepancies between the input abstracts text and the expected output labels, we explored different strategies accordingly. Framing the task as an end-to-end Relation Extraction, we evaluated the performance of standard fine-tuning as a generative task and few-shot learning with open Large Language Models (LLaMA 7B-65B). In addition to their evaluation in few-shot settings, we explore the potential of open Large Language Models (Vicuna-13B) as synthetic data generator and propose a new workflow for this purpose. All evaluated models exhibited substantial improvements when fine-tuned on synthetic abstracts rather than the original noisy data. We provide our best performing (f1-score=59.0) BioGPT-Large model for end-to-end RE of natural-products relationships along with all the generated synthetic data and the evaluation dataset. See more details at https://github.com/idiap/abroad-re.

Amid mounting concern about the reliability and credibility of machine learning research, we present a principled framework for making robust and generalizable claims: the multiverse analysis. Our framework builds upon the multiverse analysis (Steegen et al., 2016) introduced in response to psychology's own reproducibility crisis. To efficiently explore high-dimensional and often continuous ML search spaces, we model the multiverse with a Gaussian Process surrogate and apply Bayesian experimental design. Our framework is designed to facilitate drawing robust scientific conclusions about model performance, and thus our approach focuses on exploration rather than conventional optimization. In the first of two case studies, we investigate disputed claims about the relative merit of adaptive optimizers. Second, we synthesize conflicting research on the effect of learning rate on the large batch training generalization gap. For the machine learning community, the multiverse analysis is a simple and effective technique for identifying robust claims, for increasing transparency, and a step toward improved reproducibility.

Neural networks trained by gradient descent (GD) have exhibited a number of surprising generalization behaviors. First, they can achieve a perfect fit to noisy training data and still generalize near-optimally, showing that overfitting can sometimes be benign. Second, they can undergo a period of classical, harmful overfitting -- achieving a perfect fit to training data with near-random performance on test data -- before transitioning ("grokking") to near-optimal generalization later in training. In this work, we show that both of these phenomena provably occur in two-layer ReLU networks trained by GD on XOR cluster data where a constant fraction of the training labels are flipped. In this setting, we show that after the first step of GD, the network achieves 100% training accuracy, perfectly fitting the noisy labels in the training data, but achieves near-random test accuracy. At a later training step, the network achieves near-optimal test accuracy while still fitting the random labels in the training data, exhibiting a "grokking" phenomenon. This provides the first theoretical result of benign overfitting in neural network classification when the data distribution is not linearly separable. Our proofs rely on analyzing the feature learning process under GD, which reveals that the network implements a non-generalizable linear classifier after one step and gradually learns generalizable features in later steps.

Metadata are general characteristics of the data in a well-curated and condensed format, and have been proven to be useful for decision making, knowledge discovery, and also heterogeneous data organization of biobank. Among all data types in the biobank, pathology is the key component of the biobank and also serves as the gold standard of diagnosis. To maximize the utility of biobank and allow the rapid progress of biomedical science, it is essential to organize the data with well-populated pathology metadata. However, manual annotation of such information is tedious and time-consuming. In the study, we develop a multimodal multitask learning framework to predict four major slide-level metadata of pathology images. The framework learns generalizable representations across tissue slides, pathology reports, and case-level structured data. We demonstrate improved performance across all four tasks with the proposed method compared to a single modal single task baseline on two test sets, one external test set from a distinct data source (TCGA) and one internal held-out test set (TTH). In the test sets, the performance improvements on the averaged area under receiver operating characteristic curve across the four tasks are 16.48% and 9.05% on TCGA and TTH, respectively. Such pathology metadata prediction system may be adopted to mitigate the effort of expert annotation and ultimately accelerate the data-driven research by better utilization of the pathology biobank.

Efficiently and flexibly estimating treatment effect heterogeneity is an important task in a wide variety of settings ranging from medicine to marketing, and there are a considerable number of promising conditional average treatment effect estimators currently available. These, however, typically rely on the assumption that the measured covariates are enough to justify conditional exchangeability. We propose the P-learner, motivated by the R- and DR-learner, a tailored two-stage loss function for learning heterogeneous treatment effects in settings where exchangeability given observed covariates is an implausible assumption, and we wish to rely on proxy variables for causal inference. Our proposed estimator can be implemented by off-the-shelf loss-minimizing machine learning methods, which in the case of kernel regression satisfies an oracle bound on the estimated error as long as the nuisance components are estimated reasonably well.

Medical knowledge is context-dependent and requires consistent reasoning across various natural language expressions of semantically equivalent phrases. This is particularly crucial for drug names, where patients often use brand names like Advil or Tylenol instead of their generic equivalents. To study this, we create a new robustness dataset, RABBITS, to evaluate performance differences on medical benchmarks after swapping brand and generic drug names using physician expert annotations. We assess both open-source and API-based LLMs on MedQA and MedMCQA, revealing a consistent performance drop ranging from 1-10\%. Furthermore, we identify a potential source of this fragility as the contamination of test data in widely used pre-training datasets. All code is accessible at https://github.com/BittermanLab/RABBITS, and a HuggingFace leaderboard is available at https://huggingface.co/spaces/AIM-Harvard/rabbits-leaderboard.

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

We expect the generalization error to improve with more samples from a similar task, and to deteriorate with more samples from an out-of-distribution (OOD) task. In this work, we show a counter-intuitive phenomenon: the generalization error of a task can be a non-monotonic function of the number of OOD samples. As the number of OOD samples increases, the generalization error on the target task improves before deteriorating beyond a threshold. In other words, there is value in training on small amounts of OOD data. We use Fisher's Linear Discriminant on synthetic datasets and deep networks on computer vision benchmarks such as MNIST, CIFAR-10, CINIC-10, PACS and DomainNet to demonstrate and analyze this phenomenon. In the idealistic setting where we know which samples are OOD, we show that these non-monotonic trends can be exploited using an appropriately weighted objective of the target and OOD empirical risk. While its practical utility is limited, this does suggest that if we can detect OOD samples, then there may be ways to benefit from them. When we do not know which samples are OOD, we show how a number of go-to strategies such as data-augmentation, hyper-parameter optimization, and pre-training are not enough to ensure that the target generalization error does not deteriorate with the number of OOD samples in the dataset.

In this paper, we consider a real-world scenario where a model that is trained on pre-defined classes continually encounters unlabeled data that contains both known and novel classes. The goal is to continually discover novel classes while maintaining the performance in known classes. We name the setting Continual Generalized Category Discovery (C-GCD). Existing methods for novel class discovery cannot directly handle the C-GCD setting due to some unrealistic assumptions, such as the unlabeled data only containing novel classes. Furthermore, they fail to discover novel classes in a continual fashion. In this work, we lift all these assumptions and propose an approach, called MetaGCD, to learn how to incrementally discover with less forgetting. Our proposed method uses a meta-learning framework and leverages the offline labeled data to simulate the testing incremental learning process. A meta-objective is defined to revolve around two conflicting learning objectives to achieve novel class discovery without forgetting. Furthermore, a soft neighborhood-based contrastive network is proposed to discriminate uncorrelated images while attracting correlated images. We build strong baselines and conduct extensive experiments on three widely used benchmarks to demonstrate the superiority of our method.

Training models with robust group fairness properties is crucial in ethically sensitive application areas such as medical diagnosis. Despite the growing body of work aiming to minimise demographic bias in AI, this problem remains challenging. A key reason for this challenge is the fairness generalisation gap: High-capacity deep learning models can fit all training data nearly perfectly, and thus also exhibit perfect fairness during training. In this case, bias emerges only during testing when generalisation performance differs across subgroups. This motivates us to take a bi-level optimisation perspective on fair learning: Optimising the learning strategy based on validation fairness. Specifically, we consider the highly effective workflow of adapting pre-trained models to downstream medical imaging tasks using parameter-efficient fine-tuning (PEFT) techniques. There is a trade-off between updating more parameters, enabling a better fit to the task of interest vs. fewer parameters, potentially reducing the generalisation gap. To manage this tradeoff, we propose FairTune, a framework to optimise the choice of PEFT parameters with respect to fairness. We demonstrate empirically that FairTune leads to improved fairness on a range of medical imaging datasets. The code is available at https://github.com/Raman1121/FairTune

Breast cancer is a major cause of cancer death among women, emphasising the importance of early detection for improved treatment outcomes and quality of life. Mammography, the primary diagnostic imaging test, poses challenges due to the high variability and patterns in mammograms. Double reading of mammograms is recommended in many screening programs to improve diagnostic accuracy but increases radiologists' workload. Researchers explore Machine Learning models to support expert decision-making. Stand-alone models have shown comparable or superior performance to radiologists, but some studies note decreased sensitivity with multiple datasets, indicating the need for high generalisation and robustness models. This work devises MammoDG, a novel deep-learning framework for generalisable and reliable analysis of cross-domain multi-center mammography data. MammoDG leverages multi-view mammograms and a novel contrastive mechanism to enhance generalisation capabilities. Extensive validation demonstrates MammoDG's superiority, highlighting the critical importance of domain generalisation for trustworthy mammography analysis in imaging protocol variations.

If the same neural network architecture is trained multiple times on the same dataset, will it make similar linguistic generalizations across runs? To study this question, we fine-tuned 100 instances of BERT on the Multi-genre Natural Language Inference (MNLI) dataset and evaluated them on the HANS dataset, which evaluates syntactic generalization in natural language inference. On the MNLI development set, the behavior of all instances was remarkably consistent, with accuracy ranging between 83.6% and 84.8%. In stark contrast, the same models varied widely in their generalization performance. For example, on the simple case of subject-object swap (e.g., determining that "the doctor visited the lawyer" does not entail "the lawyer visited the doctor"), accuracy ranged from 0.00% to 66.2%. Such variation is likely due to the presence of many local minima that are equally attractive to a low-bias learner such as a neural network; decreasing the variability may therefore require models with stronger inductive biases.

A major barrier to deploying current machine learning models lies in their non-reliability to dataset shifts. To resolve this problem, most existing studies attempted to transfer stable information to unseen environments. Particularly, independent causal mechanisms-based methods proposed to remove mutable causal mechanisms via the do-operator. Compared to previous methods, the obtained stable predictors are more effective in identifying stable information. However, a key question remains: which subset of this whole stable information should the model transfer, in order to achieve optimal generalization ability? To answer this question, we present a comprehensive minimax analysis from a causal perspective. Specifically, we first provide a graphical condition for the whole stable set to be optimal. When this condition fails, we surprisingly find with an example that this whole stable set, although can fully exploit stable information, is not the optimal one to transfer. To identify the optimal subset under this case, we propose to estimate the worst-case risk with a novel optimization scheme over the intervention functions on mutable causal mechanisms. We then propose an efficient algorithm to search for the subset with minimal worst-case risk, based on a newly defined equivalence relation between stable subsets. Compared to the exponential cost of exhaustively searching over all subsets, our searching strategy enjoys a polynomial complexity. The effectiveness and efficiency of our methods are demonstrated on synthetic data and the diagnosis of Alzheimer's disease.

This large scale study focuses on quantifying what X-rays diagnostic prediction tasks generalize well across multiple different datasets. We present evidence that the issue of generalization is not due to a shift in the images but instead a shift in the labels. We study the cross-domain performance, agreement between models, and model representations. We find interesting discrepancies between performance and agreement where models which both achieve good performance disagree in their predictions as well as models which agree yet achieve poor performance. We also test for concept similarity by regularizing a network to group tasks across multiple datasets together and observe variation across the tasks. All code is made available online and data is publicly available: https://github.com/mlmed/torchxrayvision

Large Language Models (LLMs) have been widely applied in various professional fields. By fine-tuning the models using domain specific question and answer datasets, the professional domain knowledge and Q\&A abilities of these models have significantly improved, for example, medical professional LLMs that use fine-tuning of doctor-patient Q\&A data exhibit extraordinary disease diagnostic abilities. However, we observed that despite improvements in specific domain knowledge, the performance of medical LLM in long-context understanding has significantly declined, especially compared to general language models with similar parameters. The purpose of this study is to investigate the phenomenon of reduced performance in understanding long-context in medical LLM. We designed a series of experiments to conduct open-book professional knowledge exams on all models to evaluate their ability to read long-context. By adjusting the proportion and quantity of general data and medical data in the process of fine-tuning, we can determine the best data composition to optimize the professional model and achieve a balance between long-context performance and specific domain knowledge.

Recent works in Event Argument Extraction (EAE) have focused on improving model generalizability to cater to new events and domains. However, standard benchmarking datasets like ACE and ERE cover less than 40 event types and 25 entity-centric argument roles. Limited diversity and coverage hinder these datasets from adequately evaluating the generalizability of EAE models. In this paper, we first contribute by creating a large and diverse EAE ontology. This ontology is created by transforming FrameNet, a comprehensive semantic role labeling (SRL) dataset for EAE, by exploiting the similarity between these two tasks. Then, exhaustive human expert annotations are collected to build the ontology, concluding with 115 events and 220 argument roles, with a significant portion of roles not being entities. We utilize this ontology to further introduce GENEVA, a diverse generalizability benchmarking dataset comprising four test suites, aimed at evaluating models' ability to handle limited data and unseen event type generalization. We benchmark six EAE models from various families. The results show that owing to non-entity argument roles, even the best-performing model can only achieve 39% F1 score, indicating how GENEVA provides new challenges for generalization in EAE. Overall, our large and diverse EAE ontology can aid in creating more comprehensive future resources, while GENEVA is a challenging benchmarking dataset encouraging further research for improving generalizability in EAE. The code and data can be found at https://github.com/PlusLabNLP/GENEVA.

We introduce Radiology-GPT, a large language model for radiology. Using an instruction tuning approach on an extensive dataset of radiology domain knowledge, Radiology-GPT demonstrates superior performance compared to general language models such as StableLM, Dolly and LLaMA. It exhibits significant versatility in radiological diagnosis, research, and communication. This work serves as a catalyst for future developments in clinical NLP. The successful implementation of Radiology-GPT is indicative of the potential of localizing generative large language models, specifically tailored for distinctive medical specialties, while ensuring adherence to privacy standards such as HIPAA. The prospect of developing individualized, large-scale language models that cater to specific needs of various hospitals presents a promising direction. The fusion of conversational competence and domain-specific knowledge in these models is set to foster future development in healthcare AI. A demo of Radiology-GPT is available at https://huggingface.co/spaces/allen-eric/radiology-gpt.

Machine learning (ML) recourse techniques are increasingly used in high-stakes domains, providing end users with actions to alter ML predictions, but they assume ML developers understand what input variables can be changed. However, a recourse plan's actionability is subjective and unlikely to match developers' expectations completely. We present GAM Coach, a novel open-source system that adapts integer linear programming to generate customizable counterfactual explanations for Generalized Additive Models (GAMs), and leverages interactive visualizations to enable end users to iteratively generate recourse plans meeting their needs. A quantitative user study with 41 participants shows our tool is usable and useful, and users prefer personalized recourse plans over generic plans. Through a log analysis, we explore how users discover satisfactory recourse plans, and provide empirical evidence that transparency can lead to more opportunities for everyday users to discover counterintuitive patterns in ML models. GAM Coach is available at: https://poloclub.github.io/gam-coach/.

Domain generalization (DG) aims to learn domain-generalizable models from one or multiple source domains that can perform well in unseen target domains. Despite its recent progress, most existing work suffers from the misalignment between the difficulty level of training samples and the capability of contemporarily trained models, leading to over-fitting or under-fitting in the trained generalization model. We design MoDify, a Momentum Difficulty framework that tackles the misalignment by balancing the seesaw between the model's capability and the samples' difficulties along the training process. MoDify consists of two novel designs that collaborate to fight against the misalignment while learning domain-generalizable models. The first is MoDify-based Data Augmentation which exploits an RGB Shuffle technique to generate difficulty-aware training samples on the fly. The second is MoDify-based Network Optimization which dynamically schedules the training samples for balanced and smooth learning with appropriate difficulty. Without bells and whistles, a simple implementation of MoDify achieves superior performance across multiple benchmarks. In addition, MoDify can complement existing methods as a plug-in, and it is generic and can work for different visual recognition tasks.

Information retrieval methods often rely on a single embedding model trained on large, general-domain datasets like MSMARCO. While this approach can produce a retriever with reasonable overall performance, models trained on domain-specific data often yield better results within their respective domains. While prior work in information retrieval has tackled this through multi-task training, the topic of combining multiple domain-specific expert retrievers remains unexplored, despite its popularity in language model generation. In this work, we introduce RouterRetriever, a retrieval model that leverages multiple domain-specific experts along with a routing mechanism to select the most appropriate expert for each query. It is lightweight and allows easy addition or removal of experts without additional training. Evaluation on the BEIR benchmark demonstrates that RouterRetriever outperforms both MSMARCO-trained (+2.1 absolute nDCG@10) and multi-task trained (+3.2) models. This is achieved by employing our routing mechanism, which surpasses other routing techniques (+1.8 on average) commonly used in language modeling. Furthermore, the benefit generalizes well to other datasets, even in the absence of a specific expert on the dataset. To our knowledge, RouterRetriever is the first work to demonstrate the advantages of using multiple domain-specific expert embedding models with effective routing over a single, general-purpose embedding model in retrieval tasks.

Large language models exhibit promising general capabilities but often lack specialized knowledge for domain-specific tasks. Developing domain experts from a base model enables a range of applications without prohibitive training costs. This work demonstrates a method using continuous training and instruction fine-tuning to rapidly adapt Llama 2 base models to the Chinese medical domain. We first conduct continuous training on 1B tokens from Chinese medical references to teach relevant vocabulary and knowledge. The models are then fine-tuned on 54K examples sourced from the Chinese National Medical Licensing Examination. Experiments on Chinese medical data confirm the effectiveness of this approach, producing a model comparable to GPT-3.5-turbo while using way less computational resource. The resulting domain-specific model could be useful for various Chinese medical applications. More broadly, this provides a template for domain-specific training of large language models in areas where pre-trained models lack the required expertise, such as law, science, and engineering.

Neural networks often learn simple explanations that fit the majority of the data while memorizing exceptions that deviate from these explanations.This behavior leads to poor generalization when the learned explanations rely on spurious correlations. In this work, we formalize the interplay between memorization and generalization, showing that spurious correlations would particularly lead to poor generalization when are combined with memorization. Memorization can reduce training loss to zero, leaving no incentive to learn robust, generalizable patterns. To address this, we propose memorization-aware training (MAT), which uses held-out predictions as a signal of memorization to shift a model's logits. MAT encourages learning robust patterns invariant across distributions, improving generalization under distribution shifts.

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

Domain generalization (DG) aims to learn a robust model from source domains that generalize well on unseen target domains. Recent studies focus on generating novel domain samples or features to diversify distributions complementary to source domains. Yet, these approaches can hardly deal with the restriction that the samples synthesized from various domains can cause semantic distortion. In this paper, we propose an online one-stage Cross Contrasting Feature Perturbation (CCFP) framework to simulate domain shift by generating perturbed features in the latent space while regularizing the model prediction against domain shift. Different from the previous fixed synthesizing strategy, we design modules with learnable feature perturbations and semantic consistency constraints. In contrast to prior work, our method does not use any generative-based models or domain labels. We conduct extensive experiments on a standard DomainBed benchmark with a strict evaluation protocol for a fair comparison. Comprehensive experiments show that our method outperforms the previous state-of-the-art, and quantitative analyses illustrate that our approach can alleviate the domain shift problem in out-of-distribution (OOD) scenarios.

A key challenge of modern machine learning systems is to achieve Out-of-Distribution (OOD) generalization -- generalizing to target data whose distribution differs from that of source data. Despite its significant importance, the fundamental question of ``what are the most effective algorithms for OOD generalization'' remains open even under the standard setting of covariate shift. This paper addresses this fundamental question by proving that, surprisingly, classical Maximum Likelihood Estimation (MLE) purely using source data (without any modification) achieves the minimax optimality for covariate shift under the well-specified setting. That is, no algorithm performs better than MLE in this setting (up to a constant factor), justifying MLE is all you need. Our result holds for a very rich class of parametric models, and does not require any boundedness condition on the density ratio. We illustrate the wide applicability of our framework by instantiating it to three concrete examples -- linear regression, logistic regression, and phase retrieval. This paper further complement the study by proving that, under the misspecified setting, MLE is no longer the optimal choice, whereas Maximum Weighted Likelihood Estimator (MWLE) emerges as minimax optimal in certain scenarios.

Reading text from images (either natural scenes or documents) has been a long-standing research topic for decades, due to the high technical challenge and wide application range. Previously, individual specialist models are developed to tackle the sub-tasks of text reading (e.g., scene text recognition, handwritten text recognition and mathematical expression recognition). However, such specialist models usually cannot effectively generalize across different sub-tasks. Recently, generalist models (such as GPT-4V), trained on tremendous data in a unified way, have shown enormous potential in reading text in various scenarios, but with the drawbacks of limited accuracy and low efficiency. In this work, we propose Platypus, a generalized specialist model for text reading. Specifically, Platypus combines the best of both worlds: being able to recognize text of various forms with a single unified architecture, while achieving excellent accuracy and high efficiency. To better exploit the advantage of Platypus, we also construct a text reading dataset (called Worms), the images of which are curated from previous datasets and partially re-labeled. Experiments on standard benchmarks demonstrate the effectiveness and superiority of the proposed Platypus model. Model and data will be made publicly available at https://github.com/AlibabaResearch/AdvancedLiterateMachinery/tree/main/OCR/Platypus.

Single-task models have proven pivotal in solving specific tasks; however, they have limitations in real-world applications where multi-tasking is necessary and domain shifts are exhibited. Recently, instructional prompts have shown significant improvement towards multi-task generalization; however, the effect of instructional prompts and Multi-Task Learning (MTL) has not been systematically studied in the biomedical domain. Motivated by this, this paper explores the impact of instructional prompts for biomedical MTL. We introduce the BoX, a collection of 32 instruction tasks for Biomedical NLP across (X) various categories. Using this meta-dataset, we propose a unified model termed In-BoXBART, that can jointly learn all tasks of the BoX without any task-specific modules. To the best of our knowledge, this is the first attempt to propose a unified model in the biomedical domain and use instructions to achieve generalization across several biomedical tasks. Experimental results indicate that the proposed model: 1) outperforms the single-task baseline by ~3% and multi-task (without instruction) baseline by ~18% on an average, and 2) shows ~23% improvement compared to the single-task baseline in few-shot learning (i.e., 32 instances per task) on an average. Our analysis indicates that there is significant room for improvement across tasks in the BoX, implying the scope for future research direction.

Supervised fine-tuning (SFT) and reinforcement learning (RL) are widely used post-training techniques for foundation models. However, their roles in enhancing model generalization capabilities remain unclear. This paper studies the difference between SFT and RL on generalization and memorization, focusing on text-based rule variants and visual variants. We introduce GeneralPoints, an arithmetic reasoning card game, and adopt V-IRL, a real-world navigation environment, to assess how models trained with SFT and RL generalize to unseen variants in both textual and visual domains. We show that RL, especially when trained with an outcome-based reward, generalizes across both rule-based textual and visual variants. SFT, in contrast, tends to memorize training data and struggles to generalize out-of-distribution scenarios. Further analysis reveals that RL improves the model's underlying visual recognition capabilities, contributing to its enhanced generalization in the visual domain. Despite RL's superior generalization, we show that SFT remains essential for effective RL training; SFT stabilizes the model's output format, enabling subsequent RL to achieve its performance gains. These findings demonstrates the capability of RL for acquiring generalizable knowledge in complex, multi-modal tasks.

Recent advancements in Large Multi-modal Models (LMMs) underscore the importance of scaling by increasing image-text paired data, achieving impressive performance on general tasks. Despite their effectiveness in broad applications, generalist models are primarily trained on web-scale datasets dominated by natural images, resulting in the sacrifice of specialized capabilities for domain-specific tasks that require extensive domain prior knowledge. Moreover, directly integrating expert models tailored for specific domains is challenging due to the representational gap and imbalanced optimization between the generalist model and experts. To address these challenges, we introduce Chimera, a scalable and low-cost multi-modal pipeline designed to boost the ability of existing LMMs with domain-specific experts. Specifically, we design a progressive training strategy to integrate features from expert models into the input of a generalist LMM. To address the imbalanced optimization caused by the well-aligned general visual encoder, we introduce a novel Generalist-Specialist Collaboration Masking (GSCM) mechanism. This results in a versatile model that excels across the chart, table, math, and document domains, achieving state-of-the-art performance on multi-modal reasoning and visual content extraction tasks, both of which are challenging tasks for assessing existing LMMs.

Much research in machine learning involves finding appropriate inductive biases (e.g. convolutional neural networks, momentum-based optimizers, transformers) to promote generalization on tasks. However, quantification of the amount of inductive bias associated with these architectures and hyperparameters has been limited. We propose a novel method for efficiently computing the inductive bias required for generalization on a task with a fixed training data budget; formally, this corresponds to the amount of information required to specify well-generalizing models within a specific hypothesis space of models. Our approach involves modeling the loss distribution of random hypotheses drawn from a hypothesis space to estimate the required inductive bias for a task relative to these hypotheses. Unlike prior work, our method provides a direct estimate of inductive bias without using bounds and is applicable to diverse hypothesis spaces. Moreover, we derive approximation error bounds for our estimation approach in terms of the number of sampled hypotheses. Consistent with prior results, our empirical results demonstrate that higher dimensional tasks require greater inductive bias. We show that relative to other expressive model classes, neural networks as a model class encode large amounts of inductive bias. Furthermore, our measure quantifies the relative difference in inductive bias between different neural network architectures. Our proposed inductive bias metric provides an information-theoretic interpretation of the benefits of specific model architectures for certain tasks and provides a quantitative guide to developing tasks requiring greater inductive bias, thereby encouraging the development of more powerful inductive biases.

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

Adapting a language model into a specific domain, a.k.a `domain adaption', is a common practice when specialized knowledge, e.g. medicine, is not encapsulated in a general language model like Llama2. The challenge lies in the heterogeneity of data across the two training stages, as it varies in languages, genres, or formats. To tackle this and simplify the learning protocol, we propose to transform heterogeneous data, from the both pre-training and supervised stages, into a unified, simple input-output pair format. We validate the new protocol in the domains where proprietary LLMs like ChatGPT perform relatively poorly, such as Traditional Chinese Medicine. The developed model, HuatuoGPT-II, has shown state-of-the-art performance in Chinese medicine domain on a number of benchmarks, e.g. medical licensing exams. It even outperforms proprietary models like ChatGPT and GPT-4 in some aspects, especially in Traditional Chinese Medicine. Expert manual evaluations further validate HuatuoGPT-II's advantages over existing LLMs. Notably, HuatuoGPT-II was benchmarked in a fresh Chinese National Medical Licensing Examination where it achieved the best performance, showcasing not only its effectiveness but also its generalization capabilities.

Medical abstractive summarization faces the challenge of balancing faithfulness and informativeness. Current methods often sacrifice key information for faithfulness or introduce confabulations when prioritizing informativeness. While recent advancements in techniques like in-context learning (ICL) and fine-tuning have improved medical summarization, they often overlook crucial aspects such as faithfulness and informativeness without considering advanced methods like model reasoning and self-improvement. Moreover, the field lacks a unified benchmark, hindering systematic evaluation due to varied metrics and datasets. This paper addresses these gaps by presenting a comprehensive benchmark of six advanced abstractive summarization methods across three diverse datasets using five standardized metrics. Building on these findings, we propose uMedSum, a modular hybrid summarization framework that introduces novel approaches for sequential confabulation removal followed by key missing information addition, ensuring both faithfulness and informativeness. Our work improves upon previous GPT-4-based state-of-the-art (SOTA) medical summarization methods, significantly outperforming them in both quantitative metrics and qualitative domain expert evaluations. Notably, we achieve an average relative performance improvement of 11.8% in reference-free metrics over the previous SOTA. Doctors prefer uMedSum's summaries 6 times more than previous SOTA in difficult cases where there are chances of confabulations or missing information. These results highlight uMedSum's effectiveness and generalizability across various datasets and metrics, marking a significant advancement in medical summarization.

Decision-makers are often experts of their domain and take actions based on their domain knowledge. Doctors, for instance, may prescribe treatments by predicting the likely outcome of each available treatment. Actions of an expert thus naturally encode part of their domain knowledge, and can help make inferences within the same domain: Knowing doctors try to prescribe the best treatment for their patients, we can tell treatments prescribed more frequently are likely to be more effective. Yet in machine learning, the fact that most decision-makers are experts is often overlooked, and "expertise" is seldom leveraged as an inductive bias. This is especially true for the literature on treatment effect estimation, where often the only assumption made about actions is that of overlap. In this paper, we argue that expertise - particularly the type of expertise the decision-makers of a domain are likely to have - can be informative in designing and selecting methods for treatment effect estimation. We formally define two types of expertise, predictive and prognostic, and demonstrate empirically that: (i) the prominent type of expertise in a domain significantly influences the performance of different methods in treatment effect estimation, and (ii) it is possible to predict the type of expertise present in a dataset, which can provide a quantitative basis for model selection.

Prompt tuning is a parameter-efficient method, which learns soft prompts and conditions frozen language models to perform specific downstream tasks. Though effective, prompt tuning under few-shot settings on the one hand heavily relies on a good initialization of soft prompts. On the other hand, it can easily overfit to few-shot training samples, thereby undermining generalizability. Existing works leverage pre-training or supervised meta-learning to initialize soft prompts but they fail to data-efficiently generalize to unseen downstream tasks. To address the above problems, this paper proposes a novel Self-sUpervised meta-Prompt learning framework with MEta-gradient Regularization for few-shot generalization (SUPMER). SUPMER leverages self-supervised meta-learning with a diverse set of well-designed meta-training tasks to learn a universal prompt initialization for efficient adaptation using only unlabeled data. Additionally, it jointly meta-learns a gradient regularization function to transform raw gradients into a domain-generalizable direction, thus alleviating the problem of overfitting. Extensive experiments show that SUPMER achieves better performance for different few-shot downstream tasks, and also exhibits a stronger domain generalization ability. The code for SUPMER will be available at https://github.com/beepkh/SUPMER.

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

Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.

Recent artificial intelligence (AI) systems have reached milestones in "grand challenges" ranging from Go to protein-folding. The capability to retrieve medical knowledge, reason over it, and answer medical questions comparably to physicians has long been viewed as one such grand challenge. Large language models (LLMs) have catalyzed significant progress in medical question answering; Med-PaLM was the first model to exceed a "passing" score in US Medical Licensing Examination (USMLE) style questions with a score of 67.2% on the MedQA dataset. However, this and other prior work suggested significant room for improvement, especially when models' answers were compared to clinicians' answers. Here we present Med-PaLM 2, which bridges these gaps by leveraging a combination of base LLM improvements (PaLM 2), medical domain finetuning, and prompting strategies including a novel ensemble refinement approach. Med-PaLM 2 scored up to 86.5% on the MedQA dataset, improving upon Med-PaLM by over 19% and setting a new state-of-the-art. We also observed performance approaching or exceeding state-of-the-art across MedMCQA, PubMedQA, and MMLU clinical topics datasets. We performed detailed human evaluations on long-form questions along multiple axes relevant to clinical applications. In pairwise comparative ranking of 1066 consumer medical questions, physicians preferred Med-PaLM 2 answers to those produced by physicians on eight of nine axes pertaining to clinical utility (p < 0.001). We also observed significant improvements compared to Med-PaLM on every evaluation axis (p < 0.001) on newly introduced datasets of 240 long-form "adversarial" questions to probe LLM limitations. While further studies are necessary to validate the efficacy of these models in real-world settings, these results highlight rapid progress towards physician-level performance in medical question answering.

Single-source domain generalization attempts to learn a model on a source domain and deploy it to unseen target domains. Limiting access only to source domain data imposes two key challenges - how to train a model that can generalize and how to verify that it does. The standard practice of validation on the training distribution does not accurately reflect the model's generalization ability, while validation on the test distribution is a malpractice to avoid. In this work, we construct an independent validation set by transforming source domain images with a comprehensive list of augmentations, covering a broad spectrum of potential distribution shifts in target domains. We demonstrate a high correlation between validation and test performance for multiple methods and across various datasets. The proposed validation achieves a relative accuracy improvement over the standard validation equal to 15.4% or 1.6% when used for method selection or learning rate tuning, respectively. Furthermore, we introduce a novel family of methods that increase the shape bias through enhanced edge maps. To benefit from the augmentations during training and preserve the independence of the validation set, a k-fold validation process is designed to separate the augmentation types used in training and validation. The method that achieves the best performance on the augmented validation is selected from the proposed family. It achieves state-of-the-art performance on various standard benchmarks. Code at: https://github.com/NikosEfth/crafting-shifts

Developing robust and general-purpose robotic manipulation policies is a key goal in the field of robotics. To achieve effective generalization, it is essential to construct comprehensive datasets that encompass a large number of demonstration trajectories and diverse tasks. Unlike vision or language data that can be collected from the Internet, robotic datasets require detailed observations and manipulation actions, necessitating significant investment in hardware-software infrastructure and human labor. While existing works have focused on assembling various individual robot datasets, there remains a lack of a unified data collection standard and insufficient diversity in tasks, scenarios, and robot types. In this paper, we introduce RoboMIND (Multi-embodiment Intelligence Normative Data for Robot manipulation), featuring 55k real-world demonstration trajectories across 279 diverse tasks involving 61 different object classes. RoboMIND is collected through human teleoperation and encompasses comprehensive robotic-related information, including multi-view RGB-D images, proprioceptive robot state information, end effector details, and linguistic task descriptions. To ensure dataset consistency and reliability during policy learning, RoboMIND is built on a unified data collection platform and standardized protocol, covering four distinct robotic embodiments. We provide a thorough quantitative and qualitative analysis of RoboMIND across multiple dimensions, offering detailed insights into the diversity of our datasets. In our experiments, we conduct extensive real-world testing with four state-of-the-art imitation learning methods, demonstrating that training with RoboMIND data results in a high manipulation success rate and strong generalization. Our project is at https://x-humanoid-robomind.github.io/.

Large language models exhibit surprising emergent generalization properties, yet also struggle on many simple reasoning tasks such as arithmetic and parity. This raises the question of if and when Transformer models can learn the true algorithm for solving a task. We study the scope of Transformers' abilities in the specific setting of length generalization on algorithmic tasks. Here, we propose a unifying framework to understand when and how Transformers can exhibit strong length generalization on a given task. Specifically, we leverage RASP (Weiss et al., 2021) -- a programming language designed for the computational model of a Transformer -- and introduce the RASP-Generalization Conjecture: Transformers tend to length generalize on a task if the task can be solved by a short RASP program which works for all input lengths. This simple conjecture remarkably captures most known instances of length generalization on algorithmic tasks. Moreover, we leverage our insights to drastically improve generalization performance on traditionally hard tasks (such as parity and addition). On the theoretical side, we give a simple example where the "min-degree-interpolator" model of learning from Abbe et al. (2023) does not correctly predict Transformers' out-of-distribution behavior, but our conjecture does. Overall, our work provides a novel perspective on the mechanisms of compositional generalization and the algorithmic capabilities of Transformers.

There often is a dilemma between ease of optimization and robust out-of-distribution (OoD) generalization. For instance, many OoD methods rely on penalty terms whose optimization is challenging. They are either too strong to optimize reliably or too weak to achieve their goals. We propose to initialize the networks with a rich representation containing a palette of potentially useful features, ready to be used by even simple models. On the one hand, a rich representation provides a good initialization for the optimizer. On the other hand, it also provides an inductive bias that helps OoD generalization. Such a representation is constructed with the Rich Feature Construction (RFC) algorithm, also called the Bonsai algorithm, which consists of a succession of training episodes. During discovery episodes, we craft a multi-objective optimization criterion and its associated datasets in a manner that prevents the network from using the features constructed in the previous iterations. During synthesis episodes, we use knowledge distillation to force the network to simultaneously represent all the previously discovered features. Initializing the networks with Bonsai representations consistently helps six OoD methods achieve top performance on ColoredMNIST benchmark. The same technique substantially outperforms comparable results on the Wilds Camelyon17 task, eliminates the high result variance that plagues other methods, and makes hyperparameter tuning and model selection more reliable.

We present GR-2, a state-of-the-art generalist robot agent for versatile and generalizable robot manipulation. GR-2 is first pre-trained on a vast number of Internet videos to capture the dynamics of the world. This large-scale pre-training, involving 38 million video clips and over 50 billion tokens, equips GR-2 with the ability to generalize across a wide range of robotic tasks and environments during subsequent policy learning. Following this, GR-2 is fine-tuned for both video generation and action prediction using robot trajectories. It exhibits impressive multi-task learning capabilities, achieving an average success rate of 97.7% across more than 100 tasks. Moreover, GR-2 demonstrates exceptional generalization to new, previously unseen scenarios, including novel backgrounds, environments, objects, and tasks. Notably, GR-2 scales effectively with model size, underscoring its potential for continued growth and application. Project page: https://gr2-manipulation.github.io.

Large language models (LLMs) fine-tuned with reinforcement learning from human feedback (RLHF) have been used in some of the most widely deployed AI models to date, such as OpenAI's ChatGPT, Anthropic's Claude, or Meta's LLaMA-2. While there has been significant work developing these methods, our understanding of the benefits and downsides of each stage in RLHF is still limited. To fill this gap, we present an extensive analysis of how each stage of the process (i.e. supervised fine-tuning (SFT), reward modelling, and RLHF) affects two key properties: out-of-distribution (OOD) generalisation and output diversity. OOD generalisation is crucial given the wide range of real-world scenarios in which these models are being used, while output diversity refers to the model's ability to generate varied outputs and is important for a variety of use cases. We perform our analysis across two base models on both summarisation and instruction following tasks, the latter being highly relevant for current LLM use cases. We find that RLHF generalises better than SFT to new inputs, particularly as the distribution shift between train and test becomes larger. However, RLHF significantly reduces output diversity compared to SFT across a variety of measures, implying a tradeoff in current LLM fine-tuning methods between generalisation and diversity. Our results provide guidance on which fine-tuning method should be used depending on the application, and show that more research is needed to improve the trade-off between generalisation and diversity.

We present HealthGPT, a powerful Medical Large Vision-Language Model (Med-LVLM) that integrates medical visual comprehension and generation capabilities within a unified autoregressive paradigm. Our bootstrapping philosophy is to progressively adapt heterogeneous comprehension and generation knowledge to pre-trained large language models (LLMs). This is achieved through a novel heterogeneous low-rank adaptation (H-LoRA) technique, which is complemented by a tailored hierarchical visual perception approach and a three-stage learning strategy. To effectively learn the HealthGPT, we devise a comprehensive medical domain-specific comprehension and generation dataset called VL-Health. Experimental results demonstrate exceptional performance and scalability of HealthGPT in medical visual unified tasks. Our project can be accessed at https://github.com/DCDmllm/HealthGPT.

We propose DISC-MedLLM, a comprehensive solution that leverages Large Language Models (LLMs) to provide accurate and truthful medical response in end-to-end conversational healthcare services. To construct high-quality Supervised Fine-Tuning (SFT) datasets, we employ three strategies: utilizing medical knowledge-graphs, reconstructing real-world dialogues, and incorporating human-guided preference rephrasing. These datasets are instrumental in training DISC-MedLLM, surpassing existing medical LLMs in both single-turn and multi-turn consultation scenarios. Extensive experimental results demonstrate the effectiveness of the proposed model in bridging the gap between general language models and real-world medical consultation. Additionally, we release the constructed dataset and model weights to further contribute to research and development. Further details and resources can be found at https://github.com/FudanDISC/DISC-MedLLM

Large Language Models (LLMs) have shown significant promise as copilots in various tasks. Local deployment of LLMs on edge devices is necessary when handling privacy-sensitive data or latency-sensitive tasks. The computational constraints of such devices make direct deployment of powerful large-scale LLMs impractical, necessitating the Knowledge Distillation from large-scale models to lightweight models. Lots of work has been done to elicit diversity and quality training examples from LLMs, but little attention has been paid to aligning teacher instructional content based on student preferences, akin to "responsive teaching" in pedagogy. Thus, we propose ARTE, dubbed Aligning TeacheR with StudenT PreferencEs, a framework that aligns the teacher model with student preferences to generate tailored training examples for Knowledge Distillation. Specifically, we elicit draft questions and rationales from the teacher model, then collect student preferences on these questions and rationales using students' performance with in-context learning as a proxy, and finally align the teacher model with student preferences. In the end, we repeat the first step with the aligned teacher model to elicit tailored training examples for the student model on the target task. Extensive experiments on academic benchmarks demonstrate the superiority of ARTE over existing instruction-tuning datasets distilled from powerful LLMs. Moreover, we thoroughly investigate the generalization of ARTE, including the generalization of fine-tuned student models in reasoning ability and the generalization of aligned teacher models to generate tailored training data across tasks and students. In summary, our contributions lie in proposing a novel framework for tailored training example generation, demonstrating its efficacy in experiments, and investigating the generalization of both student & aligned teacher models in ARTE.

Foundation models (FMs) have exhibited remarkable performance across a wide range of downstream tasks in many domains. Nevertheless, general-purpose FMs often face challenges when confronted with domain-specific problems, due to their limited access to the proprietary training data in a particular domain. In biomedicine, there are various biological modalities, such as molecules, proteins, and cells, which are encoded by the language of life and exhibit significant modality gaps with human natural language. In this paper, we introduce BioMedGPT, an open multimodal generative pre-trained transformer (GPT) for biomedicine, to bridge the gap between the language of life and human natural language. BioMedGPT allows users to easily ``communicate'' with diverse biological modalities through free text, which is the first of its kind. BioMedGPT aligns different biological modalities with natural language via a large generative language model, namely, BioMedGPT-LM. We publish BioMedGPT-10B, which unifies the feature spaces of molecules, proteins, and natural language via encoding and alignment. Through fine-tuning, BioMedGPT-10B outperforms or is on par with human and significantly larger general-purpose foundation models on the biomedical QA task. It also demonstrates promising performance in the molecule QA and protein QA tasks, which could greatly accelerate the discovery of new drugs and therapeutic targets. In addition, BioMedGPT-LM-7B is the first large generative language model based on Llama2 in the biomedical domain, therefore is commercial friendly. Both BioMedGPT-10B and BioMedGPT-LM-7B are open-sourced to the research community. In addition, we publish the datasets that are meticulously curated for the alignment of multi-modalities, i.e., PubChemQA and UniProtQA. All the models, codes, and datasets are available at https://github.com/PharMolix/OpenBioMed.

Robust generalization is a major challenge in deep learning, particularly when the number of trainable parameters is very large. In general, it is very difficult to know if the network has memorized a particular set of examples or understood the underlying rule (or both). Motivated by this challenge, we study an interpretable model where generalizing representations are understood analytically, and are easily distinguishable from the memorizing ones. Namely, we consider multi-layer perceptron (MLP) and Transformer architectures trained on modular arithmetic tasks, where (xi cdot 100%) of labels are corrupted (i.e. some results of the modular operations in the training set are incorrect). We show that (i) it is possible for the network to memorize the corrupted labels and achieve 100% generalization at the same time; (ii) the memorizing neurons can be identified and pruned, lowering the accuracy on corrupted data and improving the accuracy on uncorrupted data; (iii) regularization methods such as weight decay, dropout and BatchNorm force the network to ignore the corrupted data during optimization, and achieve 100% accuracy on the uncorrupted dataset; and (iv) the effect of these regularization methods is (``mechanistically'') interpretable: weight decay and dropout force all the neurons to learn generalizing representations, while BatchNorm de-amplifies the output of memorizing neurons and amplifies the output of the generalizing ones. Finally, we show that in the presence of regularization, the training dynamics involves two consecutive stages: first, the network undergoes grokking dynamics reaching high train and test accuracy; second, it unlearns the memorizing representations, where the train accuracy suddenly jumps from 100% to 100 (1-xi)%.

The objective of domain generalization (DG) is to enhance the transferability of the model learned from a source domain to unobserved domains. To prevent overfitting to a specific domain, Sharpness-Aware Minimization (SAM) reduces source domain's loss sharpness. Although SAM variants have delivered significant improvements in DG, we highlight that there's still potential for improvement in generalizing to unknown domains through the exploration on data space. This paper introduces an objective rooted in both parameter and data perturbed regions for domain generalization, coined Unknown Domain Inconsistency Minimization (UDIM). UDIM reduces the loss landscape inconsistency between source domain and unknown domains. As unknown domains are inaccessible, these domains are empirically crafted by perturbing instances from the source domain dataset. In particular, by aligning the loss landscape acquired in the source domain to the loss landscape of perturbed domains, we expect to achieve generalization grounded on these flat minima for the unknown domains. Theoretically, we validate that merging SAM optimization with the UDIM objective establishes an upper bound for the true objective of the DG task. In an empirical aspect, UDIM consistently outperforms SAM variants across multiple DG benchmark datasets. Notably, UDIM shows statistically significant improvements in scenarios with more restrictive domain information, underscoring UDIM's generalization capability in unseen domains. Our code is available at https://github.com/SJShin-AI/UDIM.

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

We propose a new framework for estimating generative models via an adversarial process, in which we simultaneously train two models: a generative model G that captures the data distribution, and a discriminative model D that estimates the probability that a sample came from the training data rather than G. The training procedure for G is to maximize the probability of D making a mistake. This framework corresponds to a minimax two-player game. In the space of arbitrary functions G and D, a unique solution exists, with G recovering the training data distribution and D equal to 1/2 everywhere. In the case where G and D are defined by multilayer perceptrons, the entire system can be trained with backpropagation. There is no need for any Markov chains or unrolled approximate inference networks during either training or generation of samples. Experiments demonstrate the potential of the framework through qualitative and quantitative evaluation of the generated samples.

We present Generalized LoRA (GLoRA), an advanced approach for universal parameter-efficient fine-tuning tasks. Enhancing Low-Rank Adaptation (LoRA), GLoRA employs a generalized prompt module to optimize pre-trained model weights and adjust intermediate activations, providing more flexibility and capability across diverse tasks and datasets. Moreover, GLoRA facilitates efficient parameter adaptation by employing a scalable, modular, layer-wise structure search that learns individual adapter of each layer. Originating from a unified mathematical formulation, GLoRA exhibits strong transfer learning, few-shot learning and domain generalization abilities, as it adjusts to new tasks through additional dimensions on weights and activations. Comprehensive experiments demonstrate that GLoRA outperforms all previous methods in natural, specialized, and structured benchmarks, achieving superior accuracy with fewer parameters and computations on various datasets. Furthermore, our structural re-parameterization design ensures that GLoRA incurs no extra inference cost, rendering it a practical solution for resource-limited applications. Code is available at: https://github.com/Arnav0400/ViT-Slim/tree/master/GLoRA.

We study a synthetic corpus based approach for language models (LMs) to acquire logical deductive reasoning ability. The previous studies generated deduction examples using specific sets of deduction rules. However, these rules were limited or otherwise arbitrary, limiting the generalizability of acquired reasoning ability. We rethink this and adopt a well-grounded set of deduction rules based on formal logic theory, which can derive any other deduction rules when combined in a multistep way. Then, using the proposed corpora, which we name FLD (Formal Logic Deduction), we first evaluate and analyze the logical reasoning ability of the latest LLMs. Even GPT-4 can solve only half of the problems, suggesting that pure logical reasoning isolated from knowledge is still challenging for the LLMs, and additional training specialized in logical reasoning is indeed essential. We next empirically verify that LMs trained on FLD corpora acquire more generalizable reasoning ability. Furthermore, we identify the aspects of reasoning ability on which deduction corpora can enhance LMs and those on which they cannot, and discuss future directions on each aspect. The released corpora serve both as learning resources and as challenging benchmarks.

The recent success of Large Language Models (LLMs) has had a significant impact on the healthcare field, providing patients with medical advice, diagnostic information, and more. However, due to a lack of professional medical knowledge, patients are easily misled by generated erroneous information from LLMs, which may result in serious medical problems. To address this issue, we focus on tuning the LLMs to be medical assistants who collaborate with more experienced doctors. We first conduct a two-stage survey by inspiration-feedback to gain a broad understanding of the real needs of doctors for medical assistants. Based on this, we construct a Chinese medical dataset called DoctorFLAN to support the entire workflow of doctors, which includes 92K Q\&A samples from 22 tasks and 27 specialists. Moreover, we evaluate LLMs in doctor-oriented scenarios by constructing the DoctorFLAN-test containing 550 single-turn Q\&A and DotaBench containing 74 multi-turn conversations. The evaluation results indicate that being a medical assistant still poses challenges for existing open-source models, but DoctorFLAN can help them significantly. It demonstrates that the doctor-oriented dataset and benchmarks we construct can complement existing patient-oriented work and better promote medical LLMs research.

Developing generalist foundation model has recently attracted tremendous attention among researchers in the field of AI for Medicine (AI4Medicine). A pivotal insight in developing these models is their reliance on dataset scaling, which emphasizes the requirements on developing open-source medical image datasets that incorporate diverse supervision signals across various imaging modalities. In this paper, we introduce RadGenome-Chest CT, a comprehensive, large-scale, region-guided 3D chest CT interpretation dataset based on CT-RATE. Specifically, we leverage the latest powerful universal segmentation and large language models, to extend the original datasets (over 25,692 non-contrast 3D chest CT volume and reports from 20,000 patients) from the following aspects: (i) organ-level segmentation masks covering 197 categories, which provide intermediate reasoning visual clues for interpretation; (ii) 665 K multi-granularity grounded reports, where each sentence of the report is linked to the corresponding anatomical region of CT volume in the form of a segmentation mask; (iii) 1.3 M grounded VQA pairs, where questions and answers are all linked with reference segmentation masks, enabling models to associate visual evidence with textual explanations. All grounded reports and VQA pairs in the validation set have gone through manual verification to ensure dataset quality. We believe that RadGenome-Chest CT can significantly advance the development of multimodal medical foundation models, by training to generate texts based on given segmentation regions, which is unattainable with previous relevant datasets. We will release all segmentation masks, grounded reports, and VQA pairs to facilitate further research and development in this field.

Domain Generalization aims to develop models that can generalize to novel and unseen data distributions. In this work, we study how model architectures and pre-training objectives impact feature richness and propose a method to effectively leverage them for domain generalization. Specifically, given a pre-trained feature space, we first discover latent domain structures, referred to as pseudo-domains, that capture domain-specific variations in an unsupervised manner. Next, we augment existing classifiers with these complementary pseudo-domain representations making them more amenable to diverse unseen test domains. We analyze how different pre-training feature spaces differ in the domain-specific variances they capture. Our empirical studies reveal that features from diffusion models excel at separating domains in the absence of explicit domain labels and capture nuanced domain-specific information. On 5 datasets, we show that our very simple framework improves generalization to unseen domains by a maximum test accuracy improvement of over 4% compared to the standard baseline Empirical Risk Minimization (ERM). Crucially, our method outperforms most algorithms that access domain labels during training.

The proliferation of pretrained models, as a result of advancements in pretraining techniques, has led to the emergence of a vast zoo of publicly available models. Effectively utilizing these resources to obtain models with robust out-of-distribution generalization capabilities for downstream tasks has become a crucial area of research. Previous research has primarily focused on identifying the most powerful models within the model zoo, neglecting to fully leverage the diverse inductive biases contained within. This paper argues that the knowledge contained in weaker models is valuable and presents a method for leveraging the diversity within the model zoo to improve out-of-distribution generalization capabilities. Specifically, we investigate the behaviors of various pretrained models across different domains of downstream tasks by characterizing the variations in their encoded representations in terms of two dimensions: diversity shift and correlation shift. This characterization enables us to propose a new algorithm for integrating diverse pretrained models, not limited to the strongest models, in order to achieve enhanced out-of-distribution generalization performance. Our proposed method demonstrates state-of-the-art empirical results on a variety of datasets, thus validating the benefits of utilizing diverse knowledge.

The field of general time series analysis has recently begun to explore unified modeling, where a common architectural backbone can be retrained on a specific task for a specific dataset. In this work, we approach unification from a complementary vantage point: unification across tasks and domains. To this end, we explore the impact of discrete, learnt, time series data representations that enable generalist, cross-domain training. Our method, TOTEM, or TOkenized Time Series EMbeddings, proposes a simple tokenizer architecture that embeds time series data from varying domains using a discrete vectorized representation learned in a self-supervised manner. TOTEM works across multiple tasks and domains with minimal to no tuning. We study the efficacy of TOTEM with an extensive evaluation on 17 real world time series datasets across 3 tasks. We evaluate both the specialist (i.e., training a model on each domain) and generalist (i.e., training a single model on many domains) settings, and show that TOTEM matches or outperforms previous best methods on several popular benchmarks. The code can be found at: https://github.com/SaberaTalukder/TOTEM.

Domain generalization (DG) seeks to learn robust models that generalize well under unknown distribution shifts. As a critical aspect of DG, optimizer selection has not been explored in depth. Currently, most DG methods follow the widely used benchmark, DomainBed, and utilize Adam as the default optimizer for all datasets. However, we reveal that Adam is not necessarily the optimal choice for the majority of current DG methods and datasets. Based on the perspective of loss landscape flatness, we propose a novel approach, Flatness-Aware Minimization for Domain Generalization (FAD), which can efficiently optimize both zeroth-order and first-order flatness simultaneously for DG. We provide theoretical analyses of the FAD's out-of-distribution (OOD) generalization error and convergence. Our experimental results demonstrate the superiority of FAD on various DG datasets. Additionally, we confirm that FAD is capable of discovering flatter optima in comparison to other zeroth-order and first-order flatness-aware optimization methods.

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

The capabilities and limitations of Large Language Models have been sketched out in great detail in recent years, providing an intriguing yet conflicting picture. On the one hand, LLMs demonstrate a general ability to solve problems. On the other hand, they show surprising reasoning gaps when compared to humans, casting doubt on the robustness of their generalisation strategies. The sheer volume of data used in the design of LLMs has precluded us from applying the method traditionally used to measure generalisation: train-test set separation. To overcome this, we study what kind of generalisation strategies LLMs employ when performing reasoning tasks by investigating the pretraining data they rely on. For two models of different sizes (7B and 35B) and 2.5B of their pretraining tokens, we identify what documents influence the model outputs for three simple mathematical reasoning tasks and contrast this to the data that are influential for answering factual questions. We find that, while the models rely on mostly distinct sets of data for each factual question, a document often has a similar influence across different reasoning questions within the same task, indicating the presence of procedural knowledge. We further find that the answers to factual questions often show up in the most influential data. However, for reasoning questions the answers usually do not show up as highly influential, nor do the answers to the intermediate reasoning steps. When we characterise the top ranked documents for the reasoning questions qualitatively, we confirm that the influential documents often contain procedural knowledge, like demonstrating how to obtain a solution using formulae or code. Our findings indicate that the approach to reasoning the models use is unlike retrieval, and more like a generalisable strategy that synthesises procedural knowledge from documents doing a similar form of reasoning.

Offline goal-conditioned RL (GCRL) offers a way to train general-purpose agents from fully offline datasets. In addition to being conservative within the dataset, the generalization ability to achieve unseen goals is another fundamental challenge for offline GCRL. However, to the best of our knowledge, this problem has not been well studied yet. In this paper, we study out-of-distribution (OOD) generalization of offline GCRL both theoretically and empirically to identify factors that are important. In a number of experiments, we observe that weighted imitation learning enjoys better generalization than pessimism-based offline RL method. Based on this insight, we derive a theory for OOD generalization, which characterizes several important design choices. We then propose a new offline GCRL method, Generalizable Offline goAl-condiTioned RL (GOAT), by combining the findings from our theoretical and empirical studies. On a new benchmark containing 9 independent identically distributed (IID) tasks and 17 OOD tasks, GOAT outperforms current state-of-the-art methods by a large margin.

Inferring causal structure poses a combinatorial search problem that typically involves evaluating structures with a score or independence test. The resulting search is costly, and designing suitable scores or tests that capture prior knowledge is difficult. In this work, we propose to amortize causal structure learning. Rather than searching over structures, we train a variational inference model to directly predict the causal structure from observational or interventional data. This allows our inference model to acquire domain-specific inductive biases for causal discovery solely from data generated by a simulator, bypassing both the hand-engineering of suitable score functions and the search over graphs. The architecture of our inference model emulates permutation invariances that are crucial for statistical efficiency in structure learning, which facilitates generalization to significantly larger problem instances than seen during training. On synthetic data and semisynthetic gene expression data, our models exhibit robust generalization capabilities when subject to substantial distribution shifts and significantly outperform existing algorithms, especially in the challenging genomics domain. Our code and models are publicly available at: https://github.com/larslorch/avici.

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

Effective implementations of sampling-based probabilistic inference often require manually constructed, model-specific proposals. Inspired by recent progresses in meta-learning for training learning agents that can generalize to unseen environments, we propose a meta-learning approach to building effective and generalizable MCMC proposals. We parametrize the proposal as a neural network to provide fast approximations to block Gibbs conditionals. The learned neural proposals generalize to occurrences of common structural motifs across different models, allowing for the construction of a library of learned inference primitives that can accelerate inference on unseen models with no model-specific training required. We explore several applications including open-universe Gaussian mixture models, in which our learned proposals outperform a hand-tuned sampler, and a real-world named entity recognition task, in which our sampler yields higher final F1 scores than classical single-site Gibbs sampling.

The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research.

Due to domain shift, machine learning systems typically fail to generalize well to domains different from those of training data, which is what domain generalization (DG) aims to address. Although various DG methods have been developed, most of them lack interpretability and require domain labels that are not available in many real-world scenarios. This paper presents a novel DG method, called HMOE: Hypernetwork-based Mixture of Experts (MoE), which does not rely on domain labels and is more interpretable. MoE proves effective in identifying heterogeneous patterns in data. For the DG problem, heterogeneity arises exactly from domain shift. HMOE uses hypernetworks taking vectors as input to generate experts' weights, which allows experts to share useful meta-knowledge and enables exploring experts' similarities in a low-dimensional vector space. We compare HMOE with other DG algorithms under a fair and unified benchmark-DomainBed. Our extensive experiments show that HMOE can divide mixed-domain data into distinct clusters that are surprisingly more consistent with human intuition than original domain labels. Compared to other DG methods, HMOE shows competitive performance and achieves SOTA results in some cases.

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

Some reinforcement learning (RL) algorithms can stitch pieces of experience to solve a task never seen before during training. This oft-sought property is one of the few ways in which RL methods based on dynamic-programming differ from RL methods based on supervised-learning (SL). Yet, certain RL methods based on off-the-shelf SL algorithms achieve excellent results without an explicit mechanism for stitching; it remains unclear whether those methods forgo this important stitching property. This paper studies this question for the problems of achieving a target goal state and achieving a target return value. Our main result is to show that the stitching property corresponds to a form of combinatorial generalization: after training on a distribution of (state, goal) pairs, one would like to evaluate on (state, goal) pairs not seen together in the training data. Our analysis shows that this sort of generalization is different from i.i.d. generalization. This connection between stitching and generalisation reveals why we should not expect SL-based RL methods to perform stitching, even in the limit of large datasets and models. Based on this analysis, we construct new datasets to explicitly test for this property, revealing that SL-based methods lack this stitching property and hence fail to perform combinatorial generalization. Nonetheless, the connection between stitching and combinatorial generalisation also suggests a simple remedy for improving generalisation in SL: data augmentation. We propose a temporal data augmentation and demonstrate that adding it to SL-based methods enables them to successfully complete tasks not seen together during training. On a high level, this connection illustrates the importance of combinatorial generalization for data efficiency in time-series data beyond tasks beyond RL, like audio, video, or text.

The goal of continual learning is to find a model that solves multiple learning tasks which are presented sequentially to the learner. A key challenge in this setting is that the learner may forget how to solve a previous task when learning a new task, a phenomenon known as catastrophic forgetting. To address this challenge, many practical methods have been proposed, including memory-based, regularization-based, and expansion-based methods. However, a rigorous theoretical understanding of these methods remains elusive. This paper aims to bridge this gap between theory and practice by proposing a new continual learning framework called Ideal Continual Learner (ICL), which is guaranteed to avoid catastrophic forgetting by construction. We show that ICL unifies multiple well-established continual learning methods and gives new theoretical insights into the strengths and weaknesses of these methods. We also derive generalization bounds for ICL which allow us to theoretically quantify how rehearsal affects generalization. Finally, we connect ICL to several classic subjects and research topics of modern interest, which allows us to make historical remarks and inspire future directions.

Knowledge-intensive language tasks (KILTs) benefit from retrieving high-quality relevant contexts from large external knowledge corpora. Learning task-specific retrievers that return relevant contexts at an appropriate level of semantic granularity, such as a document retriever, passage retriever, sentence retriever, and entity retriever, may help to achieve better performance on the end-to-end task. But a task-specific retriever usually has poor generalization ability to new domains and tasks, and it may be costly to deploy a variety of specialised retrievers in practice. We propose a unified generative retriever (UGR) that combines task-specific effectiveness with robust performance over different retrieval tasks in KILTs. To achieve this goal, we make two major contributions: (i) To unify different retrieval tasks into a single generative form, we introduce an n-gram-based identifier for relevant contexts at different levels of granularity in KILTs. And (ii) to address different retrieval tasks with a single model, we employ a prompt learning strategy and investigate three methods to design prompt tokens for each task. In this way, the proposed UGR model can not only share common knowledge across tasks for better generalization, but also perform different retrieval tasks effectively by distinguishing task-specific characteristics. We train UGR on a heterogeneous set of retrieval corpora with well-designed prompts in a supervised and multi-task fashion. Experimental results on the KILT benchmark demonstrate the effectiveness of UGR on in-domain datasets, out-of-domain datasets, and unseen tasks.

Medical information retrieval (MIR) is essential for retrieving relevant medical knowledge from diverse sources, including electronic health records, scientific literature, and medical databases. However, achieving effective zero-shot dense retrieval in the medical domain poses substantial challenges due to the lack of relevance-labeled data. In this paper, we introduce a novel approach called Self-Learning Hypothetical Document Embeddings (SL-HyDE) to tackle this issue. SL-HyDE leverages large language models (LLMs) as generators to generate hypothetical documents based on a given query. These generated documents encapsulate key medical context, guiding a dense retriever in identifying the most relevant documents. The self-learning framework progressively refines both pseudo-document generation and retrieval, utilizing unlabeled medical corpora without requiring any relevance-labeled data. Additionally, we present the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation framework grounded in real-world medical scenarios, encompassing five tasks and ten datasets. By benchmarking ten models on CMIRB, we establish a rigorous standard for evaluating medical information retrieval systems. Experimental results demonstrate that SL-HyDE significantly surpasses existing methods in retrieval accuracy while showcasing strong generalization and scalability across various LLM and retriever configurations. CMIRB data and evaluation code are publicly available at: https://github.com/CMIRB-benchmark/CMIRB.

Domain generalization (DG) aims to tackle the distribution shift between training domains and unknown target domains. Generating new domains is one of the most effective approaches, yet its performance gain depends on the distribution discrepancy between the generated and target domains. Distributionally robust optimization is promising to tackle distribution discrepancy by exploring domains in an uncertainty set. However, the uncertainty set may be overwhelmingly large, leading to low-confidence prediction in DG. It is because a large uncertainty set could introduce domains containing semantically different factors from training domains. To address this issue, we propose to perform a moderately distributional exploration (MODE) for domain generalization. Specifically, MODE performs distribution exploration in an uncertainty subset that shares the same semantic factors with the training domains. We show that MODE can endow models with provable generalization performance on unknown target domains. The experimental results show that MODE achieves competitive performance compared to state-of-the-art baselines.

Instrumental variable methods have been widely used to identify causal effects in the presence of unmeasured confounding. A key identification condition known as the exclusion restriction states that the instrument cannot have a direct effect on the outcome which is not mediated by the exposure in view. In the health and social sciences, such an assumption is often not credible. To address this concern, we consider identification conditions of the population average treatment effect with an invalid instrumental variable which does not satisfy the exclusion restriction, and derive the efficient influence function targeting the identifying functional under a nonparametric observed data model. We propose a novel multiply robust locally efficient estimator of the average treatment effect that is consistent in the union of multiple parametric nuisance models, as well as a multiply debiased machine learning estimator for which the nuisance parameters are estimated using generic machine learning methods, that effectively exploit various forms of linear or nonlinear structured sparsity in the nuisance parameter space. When one cannot be confident that any of these machine learners is consistent at sufficiently fast rates to ensure n-consistency for the average treatment effect, we introduce a new criteria for selective machine learning which leverages the multiple robustness property in order to ensure small bias. The proposed methods are illustrated through extensive simulations and a data analysis evaluating the causal effect of 401(k) participation on savings.

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.

Despite significant advancements in general artificial intelligence, such as GPT-4, their effectiveness in the medical domain (general medical AI, GMAI) remains constrained due to the absence of specialized medical knowledge. To address this challenge, we present GMAI-VL-5.5M, a comprehensive multimodal medical dataset created by converting hundreds of specialized medical datasets into meticulously constructed image-text pairs. This dataset features comprehensive task coverage, diverse modalities, and high-quality image-text data. Building upon this multimodal dataset, we propose GMAI-VL, a general medical vision-language model with a progressively three-stage training strategy. This approach significantly enhances the model's ability by integrating visual and textual information, thereby improving its ability to process multimodal data and support accurate diagnosis and clinical decision-making. Experimental evaluations demonstrate that GMAI-VL achieves state-of-the-art results across a wide range of multimodal medical tasks, such as visual question answering and medical image diagnosis. Our contributions include the development of the GMAI-VL-5.5M dataset, the introduction of the GMAI-VL model, and the establishment of new benchmarks in multiple medical domains. Code and dataset will be released at https://github.com/uni-medical/GMAI-VL.

Recent advances in large language models (LLMs) have demonstrated exceptional performance in various natural language processing (NLP) tasks. However, their effective application in the medical domain is hampered by a lack of medical domain knowledge. In this study, we present SA-MDKIF, a scalable and adaptable framework that aims to inject medical knowledge into general-purpose LLMs through instruction tuning, thereby enabling adaptability for various downstream tasks. SA-MDKIF consists of two stages: skill training and skill adaptation. In the first stage, we define 12 basic medical skills and use AdaLoRA to train these skills based on uniformly formatted instructional datasets that we have constructed. In the next stage, we train the skill router using task-specific downstream data and use this router to integrate the acquired skills with LLMs during inference. Experimental results on 9 different medical tasks show that SA-MDKIF improves performance by 10-20% compared to the original LLMs. Notably, this improvement is particularly pronounced for unseen medical tasks, showing an improvement of up to 30%.

Open-source, multilingual medical large language models (LLMs) have the potential to serve linguistically diverse populations across different regions. Adapting generic LLMs for healthcare often requires continual pretraining, but this approach is computationally expensive and sometimes impractical. Instruction fine-tuning on a specific task may not always guarantee optimal performance due to the lack of broader domain knowledge that the model needs to understand and reason effectively in diverse scenarios. To address these challenges, we introduce two multilingual instruction fine-tuning datasets, MMed-IFT and MMed-IFT-MC, containing over 200k high-quality medical samples in six languages. We propose a two-stage training paradigm: the first stage injects general medical knowledge using MMed-IFT, while the second stage fine-tunes task-specific multiple-choice questions with MMed-IFT-MC. Our method achieves competitive results on both English and multilingual benchmarks, striking a balance between computational efficiency and performance. We plan to make our dataset and model weights public at https://github.com/SpassMed/Med-Llama3 in the future.

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

Recognizing the prevalence of domain shift as a common challenge in machine learning, various domain generalization (DG) techniques have been developed to enhance the performance of machine learning systems when dealing with out-of-distribution (OOD) data. Furthermore, in real-world scenarios, data distributions can gradually change across a sequence of sequential domains. While current methodologies primarily focus on improving model effectiveness within these new domains, they often overlook fairness issues throughout the learning process. In response, we introduce an innovative framework called Counterfactual Fairness-Aware Domain Generalization with Sequential Autoencoder (CDSAE). This approach effectively separates environmental information and sensitive attributes from the embedded representation of classification features. This concurrent separation not only greatly improves model generalization across diverse and unfamiliar domains but also effectively addresses challenges related to unfair classification. Our strategy is rooted in the principles of causal inference to tackle these dual issues. To examine the intricate relationship between semantic information, sensitive attributes, and environmental cues, we systematically categorize exogenous uncertainty factors into four latent variables: 1) semantic information influenced by sensitive attributes, 2) semantic information unaffected by sensitive attributes, 3) environmental cues influenced by sensitive attributes, and 4) environmental cues unaffected by sensitive attributes. By incorporating fairness regularization, we exclusively employ semantic information for classification purposes. Empirical validation on synthetic and real-world datasets substantiates the effectiveness of our approach, demonstrating improved accuracy levels while ensuring the preservation of fairness in the evolving landscape of continuous domains.

Many recent machine learning tasks focus to develop models that can generalize to unseen distributions. Domain generalization (DG) has become one of the key topics in various fields. Several literatures show that DG can be arbitrarily hard without exploiting target domain information. To address this issue, test-time adaptive (TTA) methods are proposed. Existing TTA methods require offline target data or extra sophisticated optimization procedures during the inference stage. In this work, we adopt Non-Parametric Classifier to perform the test-time Adaptation (AdaNPC). In particular, we construct a memory that contains the feature and label pairs from training domains. During inference, given a test instance, AdaNPC first recalls K closed samples from the memory to vote for the prediction, and then the test feature and predicted label are added to the memory. In this way, the sample distribution in the memory can be gradually changed from the training distribution towards the test distribution with very little extra computation cost. We theoretically justify the rationality behind the proposed method. Besides, we test our model on extensive numerical experiments. AdaNPC significantly outperforms competitive baselines on various DG benchmarks. In particular, when the adaptation target is a series of domains, the adaptation accuracy of AdaNPC is 50% higher than advanced TTA methods. The code is available at https://github.com/yfzhang114/AdaNPC.

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

This paper considers the learning of logical (Boolean) functions with focus on the generalization on the unseen (GOTU) setting, a strong case of out-of-distribution generalization. This is motivated by the fact that the rich combinatorial nature of data in certain reasoning tasks (e.g., arithmetic/logic) makes representative data sampling challenging, and learning successfully under GOTU gives a first vignette of an 'extrapolating' or 'reasoning' learner. We then study how different network architectures trained by (S)GD perform under GOTU and provide both theoretical and experimental evidence that for a class of network models including instances of Transformers, random features models, and diagonal linear networks, a min-degree-interpolator (MDI) is learned on the unseen. We also provide evidence that other instances with larger learning rates or mean-field networks reach leaky MDIs. These findings lead to two implications: (1) we provide an explanation to the length generalization problem (e.g., Anil et al. 2022); (2) we introduce a curriculum learning algorithm called Degree-Curriculum that learns monomials more efficiently by incrementing supports.

Large language models (LLMs) demonstrate remarkable medical expertise, but data privacy concerns impede their direct use in healthcare environments. Although offering improved data privacy protection, domain-specific small language models (SLMs) often underperform LLMs, emphasizing the need for methods that reduce this performance gap while alleviating privacy concerns. In this paper, we present a simple yet effective method that harnesses LLMs' medical proficiency to boost SLM performance in medical tasks under privacy-restricted scenarios. Specifically, we mitigate patient privacy issues by extracting keywords from medical data and prompting the LLM to generate a medical knowledge-intensive context by simulating clinicians' thought processes. This context serves as additional input for SLMs, augmenting their decision-making capabilities. Our method significantly enhances performance in both few-shot and full training settings across three medical knowledge-intensive tasks, achieving up to a 22.57% increase in absolute accuracy compared to SLM fine-tuning without context, and sets new state-of-the-art results in two medical tasks within privacy-restricted scenarios. Further out-of-domain testing and experiments in two general domain datasets showcase its generalizability and broad applicability.

Large Language Models (LLMs) such as GPT & Llama have demonstrated significant achievements in summarization tasks but struggle with factual inaccuracies, a critical issue in clinical NLP applications where errors could lead to serious consequences. To counter the high costs and limited availability of expert-annotated data for factual alignment, this study introduces an innovative pipeline that utilizes >100B parameter GPT variants like GPT-3.5 & GPT-4 to act as synthetic experts to generate high-quality synthetics feedback aimed at enhancing factual consistency in clinical note summarization. Our research primarily focuses on edit feedback generated by these synthetic feedback experts without additional human annotations, mirroring and optimizing the practical scenario in which medical professionals refine AI system outputs. Although such 100B+ parameter GPT variants have proven to demonstrate expertise in various clinical NLP tasks, such as the Medical Licensing Examination, there is scant research on their capacity to act as synthetic feedback experts and deliver expert-level edit feedback for improving the generation quality of weaker (<10B parameter) LLMs like GPT-2 (1.5B) & Llama 2 (7B) in clinical domain. So in this work, we leverage 100B+ GPT variants to act as synthetic feedback experts offering expert-level edit feedback, that is used to reduce hallucinations and align weaker (<10B parameter) LLMs with medical facts using two distinct alignment algorithms (DPO & SALT), endeavoring to narrow the divide between AI-generated content and factual accuracy. This highlights the substantial potential of LLM-based synthetic edits in enhancing the alignment of clinical factuality.

Artificial intelligence (AI) has demonstrated significant potential in ECG analysis and cardiovascular disease assessment. Recently, foundation models have played a remarkable role in advancing medical AI. The development of an ECG foundation model holds the promise of elevating AI-ECG research to new heights. However, building such a model faces several challenges, including insufficient database sample sizes and inadequate generalization across multiple domains. Additionally, there is a notable performance gap between single-lead and multi-lead ECG analyses. We introduced an ECG Foundation Model (ECGFounder), a general-purpose model that leverages real-world ECG annotations from cardiology experts to broaden the diagnostic capabilities of ECG analysis. ECGFounder was trained on over 10 million ECGs with 150 label categories from the Harvard-Emory ECG Database, enabling comprehensive cardiovascular disease diagnosis through ECG analysis. The model is designed to be both an effective out-of-the-box solution, and a to be fine-tunable for downstream tasks, maximizing usability. Importantly, we extended its application to lower rank ECGs, and arbitrary single-lead ECGs in particular. ECGFounder is applicable to supporting various downstream tasks in mobile monitoring scenarios. Experimental results demonstrate that ECGFounder achieves expert-level performance on internal validation sets, with AUROC exceeding 0.95 for eighty diagnoses. It also shows strong classification performance and generalization across various diagnoses on external validation sets. When fine-tuned, ECGFounder outperforms baseline models in demographic analysis, clinical event detection, and cross-modality cardiac rhythm diagnosis. The trained model and data will be publicly released upon publication through the bdsp.io. Our code is available at https://github.com/bdsp-core/ECGFounder

Given the intractably large size of the space of proofs, any model that is capable of general deductive reasoning must generalize to proofs of greater complexity. Recent studies have shown that large language models (LLMs) possess some abstract deductive reasoning ability given chain-of-thought prompts. However, they have primarily been tested on proofs using modus ponens or of a specific size, and from the same distribution as the in-context examples. To measure the general deductive reasoning ability of LLMs, we test on a broad set of deduction rules and measure their ability to generalize to more complex proofs from simpler demonstrations from multiple angles: depth-, width-, and compositional generalization. To facilitate systematic exploration, we construct a new synthetic and programmable reasoning dataset that enables control over deduction rules and proof complexity. Our experiments on four LLMs of various sizes and training objectives show that they are able to generalize to longer and compositional proofs. However, they require explicit demonstrations to produce hypothetical subproofs, specifically in proof by cases and proof by contradiction.

Open-domain Question Answering (OpenQA) aims at answering factual questions with an external large-scale knowledge corpus. However, real-world knowledge is not static; it updates and evolves continually. Such a dynamic characteristic of knowledge poses a vital challenge for these models, as the trained models need to constantly adapt to the latest information to make sure that the answers remain accurate. In addition, it is still unclear how well an OpenQA model can transfer to completely new knowledge domains. In this paper, we investigate the generalization performance of a retrieval-augmented QA model in two specific scenarios: 1) adapting to updated versions of the same knowledge corpus; 2) switching to completely different knowledge domains. We observe that the generalization challenges of OpenQA models stem from the reader's over-reliance on memorizing the knowledge from the external corpus, which hinders the model from generalizing to a new knowledge corpus. We introduce Corpus-Invariant Tuning (CIT), a simple but effective training strategy, to mitigate the knowledge over-memorization by controlling the likelihood of retrieved contexts during training. Extensive experimental results on multiple OpenQA benchmarks show that CIT achieves significantly better generalizability without compromising the model's performance in its original corpus and domain.

Recently, Large Language Models (LLMs) have showcased remarkable capabilities in natural language understanding. While demonstrating proficiency in everyday conversations and question-answering situations, these models frequently struggle in domains that require precision, such as medical applications, due to their lack of domain-specific knowledge. In this paper, we describe the procedure for building a powerful, open-source language model specifically designed for medicine applications, termed as PMC-LLaMA. Our contributions are threefold: (i) we systematically investigate the process of adapting a general-purpose foundation language model towards medical domain, this involves data-centric knowledge injection through the integration of 4.8M biomedical academic papers and 30K medical textbooks, as well as comprehensive fine-tuning for alignment with domain-specific instructions; (ii) we contribute a large-scale, comprehensive dataset for instruction tuning. This dataset encompasses medical question-answering (QA), rationale for reasoning, and conversational dialogues, comprising a total of 202M tokens; (iii) we conduct thorough ablation studies to demonstrate the effectiveness of each proposed component. While evaluating on various public medical question-answering benchmarks, our lightweight PMCLLaMA, which consists of only 13 billion parameters, exhibits superior performance, even surpassing ChatGPT. All models, codes, datasets can be found in https://github.com/chaoyi-wu/PMC-LLaMA.

We study the problem of adaptively identifying patient subpopulations that benefit from a given treatment during a confirmatory clinical trial. This type of adaptive clinical trial has been thoroughly studied in biostatistics, but has been allowed only limited adaptivity so far. Here, we aim to relax classical restrictions on such designs and investigate how to incorporate ideas from the recent machine learning literature on adaptive and online experimentation to make trials more flexible and efficient. We find that the unique characteristics of the subpopulation selection problem -- most importantly that (i) one is usually interested in finding subpopulations with any treatment benefit (and not necessarily the single subgroup with largest effect) given a limited budget and that (ii) effectiveness only has to be demonstrated across the subpopulation on average -- give rise to interesting challenges and new desiderata when designing algorithmic solutions. Building on these findings, we propose AdaGGI and AdaGCPI, two meta-algorithms for subpopulation construction. We empirically investigate their performance across a range of simulation scenarios and derive insights into their (dis)advantages across different settings.

We introduce RJUA-QA, a novel medical dataset for question answering (QA) and reasoning with clinical evidence, contributing to bridge the gap between general large language models (LLMs) and medical-specific LLM applications. RJUA-QA is derived from realistic clinical scenarios and aims to facilitate LLMs in generating reliable diagnostic and advice. The dataset contains 2,132 curated Question-Context-Answer pairs, corresponding about 25,000 diagnostic records and clinical cases. The dataset covers 67 common urological disease categories, where the disease coverage exceeds 97.6\% of the population seeking medical services in urology. Each data instance in RJUA-QA comprises: (1) a question mirroring real patient to inquiry about clinical symptoms and medical conditions, (2) a context including comprehensive expert knowledge, serving as a reference for medical examination and diagnosis, (3) a doctor response offering the diagnostic conclusion and suggested examination guidance, (4) a diagnosed clinical disease as the recommended diagnostic outcome, and (5) clinical advice providing recommendations for medical examination. RJUA-QA is the first medical QA dataset for clinical reasoning over the patient inquiries, where expert-level knowledge and experience are required for yielding diagnostic conclusions and medical examination advice. A comprehensive evaluation is conducted to evaluate the performance of both medical-specific and general LLMs on the RJUA-QA dataset.

Recent researches of large language models(LLM), which is pre-trained on massive general-purpose corpora, have achieved breakthroughs in responding human queries. However, these methods face challenges including limited data insufficiency to support extensive pre-training and can not align responses with users' instructions. To address these issues, we introduce a medical instruction dataset, CMedINS, containing six medical instructions derived from actual medical tasks, which effectively fine-tunes LLM in conjunction with other data. Subsequently, We launch our medical model, IIMedGPT, employing an efficient preference alignment method, Direct preference Optimization(DPO). The results show that our final model outperforms existing medical models in medical dialogue.Datsets, Code and model checkpoints will be released upon acceptance.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

In this paper we propose to study generalization of neural networks on small algorithmically generated datasets. In this setting, questions about data efficiency, memorization, generalization, and speed of learning can be studied in great detail. In some situations we show that neural networks learn through a process of "grokking" a pattern in the data, improving generalization performance from random chance level to perfect generalization, and that this improvement in generalization can happen well past the point of overfitting. We also study generalization as a function of dataset size and find that smaller datasets require increasing amounts of optimization for generalization. We argue that these datasets provide a fertile ground for studying a poorly understood aspect of deep learning: generalization of overparametrized neural networks beyond memorization of the finite training dataset.

We propose a new bound for generalization of neural networks using Koopman operators. Whereas most of existing works focus on low-rank weight matrices, we focus on full-rank weight matrices. Our bound is tighter than existing norm-based bounds when the condition numbers of weight matrices are small. Especially, it is completely independent of the width of the network if the weight matrices are orthogonal. Our bound does not contradict to the existing bounds but is a complement to the existing bounds. As supported by several existing empirical results, low-rankness is not the only reason for generalization. Furthermore, our bound can be combined with the existing bounds to obtain a tighter bound. Our result sheds new light on understanding generalization of neural networks with full-rank weight matrices, and it provides a connection between operator-theoretic analysis and generalization of neural networks.

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

Instruction tuning -- fine-tuning a large language model (LLM) on pairs of instructions and desired outcomes -- is an approach that enables pre-trained language models to perform real-world tasks and follow human instructions. Its practical success depends on the model learning a broader set of instructions than those it was trained on. Yet the factors that determine model generalization to such unseen tasks are not well understood. %To understand the driving factors of generalization, In this paper, we experiment with string rewrites, a symbolic task that serves as a building block for Turing complete Markov algorithms while allowing experimental control of "inputs" and "instructions". We investigate the trade-off between the number of instructions the model is trained on and the number of training samples provided for each instruction and observe that the diversity of the instruction set determines generalization. Generalization emerges once a diverse enough set of tasks is provided, even though very few examples are provided for each task. Instruction diversity also ensures robustness with respect to non-uniform distributions of instructions in the training set.

How can we train models to perform well on hard test data when hard training data is by definition difficult to label correctly? This question has been termed the scalable oversight problem and has drawn increasing attention as language models have continually improved. In this paper, we present the surprising conclusion that current language models often generalize relatively well from easy to hard data, even performing as well as "oracle" models trained on hard data. We demonstrate this kind of easy-to-hard generalization using simple training methods like in-context learning, linear classifier heads, and QLoRA for seven different measures of datapoint hardness, including six empirically diverse human hardness measures (like grade level) and one model-based measure (loss-based). Furthermore, we show that even if one cares most about model performance on hard data, it can be better to collect and train on easy data rather than hard data, since hard data is generally noisier and costlier to collect. Our experiments use open models up to 70b in size and four publicly available question-answering datasets with questions ranging in difficulty from 3rd grade science questions to college level STEM questions and general-knowledge trivia. We conclude that easy-to-hard generalization in LMs is surprisingly strong for the tasks studied, suggesting the scalable oversight problem may be easier than previously thought. Our code is available at https://github.com/allenai/easy-to-hard-generalization

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

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

A major goal of unsupervised learning is to discover data representations that are useful for subsequent tasks, without access to supervised labels during training. Typically, this involves minimizing a surrogate objective, such as the negative log likelihood of a generative model, with the hope that representations useful for subsequent tasks will arise as a side effect. In this work, we propose instead to directly target later desired tasks by meta-learning an unsupervised learning rule which leads to representations useful for those tasks. Specifically, we target semi-supervised classification performance, and we meta-learn an algorithm -- an unsupervised weight update rule -- that produces representations useful for this task. Additionally, we constrain our unsupervised update rule to a be a biologically-motivated, neuron-local function, which enables it to generalize to different neural network architectures, datasets, and data modalities. We show that the meta-learned update rule produces useful features and sometimes outperforms existing unsupervised learning techniques. We further show that the meta-learned unsupervised update rule generalizes to train networks with different widths, depths, and nonlinearities. It also generalizes to train on data with randomly permuted input dimensions and even generalizes from image datasets to a text task.

Recent advancements in Large Language Models (LLMs) have demonstrated their potential in delivering accurate answers to questions about world knowledge. Despite this, existing benchmarks for evaluating LLMs in healthcare predominantly focus on medical doctors, leaving other critical healthcare professions underrepresented. To fill this research gap, we introduce the Examinations for Medical Personnel in Chinese (EMPEC), a pioneering large-scale healthcare knowledge benchmark in traditional Chinese. EMPEC consists of 157,803 exam questions across 124 subjects and 20 healthcare professions, including underrepresented occupations like Optometrists and Audiologists. Each question is tagged with its release time and source, ensuring relevance and authenticity. We conducted extensive experiments on 17 LLMs, including proprietary, open-source models, general domain models and medical specific models, evaluating their performance under various settings. Our findings reveal that while leading models like GPT-4 achieve over 75\% accuracy, they still struggle with specialized fields and alternative medicine. Surprisingly, general-purpose LLMs outperformed medical-specific models, and incorporating EMPEC's training data significantly enhanced performance. Additionally, the results on questions released after the models' training cutoff date were consistent with overall performance trends, suggesting that the models' performance on the test set can predict their effectiveness in addressing unseen healthcare-related queries. The transition from traditional to simplified Chinese characters had a negligible impact on model performance, indicating robust linguistic versatility. Our study underscores the importance of expanding benchmarks to cover a broader range of healthcare professions to better assess the applicability of LLMs in real-world healthcare scenarios.

Graphs are essential data structures for modeling complex interactions in domains such as social networks, molecular structures, and biological systems. Graph-level tasks, which predict properties or classes for the entire graph, are critical for applications, such as molecular property prediction and subgraph counting. Graph Neural Networks (GNNs) have shown promise in these tasks, but their evaluations are often limited to narrow datasets, tasks, and inconsistent experimental setups, restricting their generalizability. To address these limitations, we propose a unified evaluation framework for graph-level GNNs. This framework provides a standardized setting to evaluate GNNs across diverse datasets, various graph tasks (e.g., graph classification and regression), and challenging scenarios, including noisy, imbalanced, and few-shot graphs. Additionally, we propose a novel GNN model with enhanced expressivity and generalization capabilities. Specifically, we enhance the expressivity of GNNs through a k-path rooted subgraph approach, enabling the model to effectively count subgraphs (e.g., paths and cycles). Moreover, we introduce a unified graph contrastive learning algorithm for graphs across diverse domains, which adaptively removes unimportant edges to augment graphs, thereby significantly improving generalization performance. Extensive experiments demonstrate that our model achieves superior performance against fourteen effective baselines across twenty-seven graph datasets, establishing it as a robust and generalizable model for graph-level tasks.

While large language models (LLMs) have been successfully applied to various tasks, they still face challenges with hallucinations. Augmenting LLMs with domain-specific tools such as database utilities can facilitate easier and more precise access to specialized knowledge. In this paper, we present GeneGPT, a novel method for teaching LLMs to use the Web APIs of the National Center for Biotechnology Information (NCBI) for answering genomics questions. Specifically, we prompt Codex to solve the GeneTuring tests with NCBI Web APIs by in-context learning and an augmented decoding algorithm that can detect and execute API calls. Experimental results show that GeneGPT achieves state-of-the-art performance on eight tasks in the GeneTuring benchmark with an average score of 0.83, largely surpassing retrieval-augmented LLMs such as the new Bing (0.44), biomedical LLMs such as BioMedLM (0.08) and BioGPT (0.04), as well as GPT-3 (0.16) and ChatGPT (0.12). Our further analyses suggest that: (1) API demonstrations have good cross-task generalizability and are more useful than documentations for in-context learning; (2) GeneGPT can generalize to longer chains of API calls and answer multi-hop questions in GeneHop, a novel dataset introduced in this work; (3) Different types of errors are enriched in different tasks, providing valuable insights for future improvements.

Publicly available source-code libraries are continuously growing and changing. This makes it impossible for models of code to keep current with all available APIs by simply training these models on existing code repositories. Thus, existing models inherently cannot generalize to using unseen functions and libraries, because these would never appear in the training data. In contrast, when human programmers use functions and libraries for the first time, they frequently refer to textual resources such as code manuals and documentation, to explore and understand the available functionality. Inspired by this observation, we introduce DocPrompting: a natural-language-to-code generation approach that explicitly leverages documentation by (1) retrieving the relevant documentation pieces given an NL intent, and (2) generating code based on the NL intent and the retrieved documentation. DocPrompting is general: it can be applied to any programming language and is agnostic to the underlying neural model. We demonstrate that DocPrompting consistently improves NL-to-code models: DocPrompting improves strong base models such as CodeT5 by 2.85% in pass@1 (52% relative gain) and 4.39% in pass@10 (30% relative gain) in execution-based evaluation on the popular Python CoNaLa benchmark; on a new Bash dataset tldr, DocPrompting improves CodeT5 and GPT-Neo1.3B by up to absolute 6.9% exact match.

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

Heterogeneity and comorbidity are two interwoven challenges associated with various healthcare problems that greatly hampered research on developing effective treatment and understanding of the underlying neurobiological mechanism. Very few studies have been conducted to investigate heterogeneous causal effects (HCEs) in graphical contexts due to the lack of statistical methods. To characterize this heterogeneity, we first conceptualize heterogeneous causal graphs (HCGs) by generalizing the causal graphical model with confounder-based interactions and multiple mediators. Such confounders with an interaction with the treatment are known as moderators. This allows us to flexibly produce HCGs given different moderators and explicitly characterize HCEs from the treatment or potential mediators on the outcome. We establish the theoretical forms of HCEs and derive their properties at the individual level in both linear and nonlinear models. An interactive structural learning is developed to estimate the complex HCGs and HCEs with confidence intervals provided. Our method is empirically justified by extensive simulations and its practical usefulness is illustrated by exploring causality among psychiatric disorders for trauma survivors.

Developing clinical prediction models (e.g., mortality prediction) based on electronic health records (EHRs) typically relies on expert opinion for feature selection and adjusting observation window size. This burdens experts and creates a bottleneck in the development process. We propose Retrieval-Enhanced Medical prediction model (REMed) to address such challenges. REMed can essentially evaluate an unlimited number of clinical events, select the relevant ones, and make predictions. This approach effectively eliminates the need for manual feature selection and enables an unrestricted observation window. We verified these properties through experiments on 27 clinical tasks and two independent cohorts from publicly available EHR datasets, where REMed outperformed other contemporary architectures that aim to handle as many events as possible. Notably, we found that the preferences of REMed align closely with those of medical experts. We expect our approach to significantly expedite the development of EHR prediction models by minimizing clinicians' need for manual involvement.

Pre-trained vision-language models (e.g., CLIP) have shown promising zero-shot generalization in many downstream tasks with properly designed text prompts. Instead of relying on hand-engineered prompts, recent works learn prompts using the training data from downstream tasks. While effective, training on domain-specific data reduces a model's generalization capability to unseen new domains. In this work, we propose test-time prompt tuning (TPT), a method that can learn adaptive prompts on the fly with a single test sample. For image classification, TPT optimizes the prompt by minimizing the entropy with confidence selection so that the model has consistent predictions across different augmented views of each test sample. In evaluating generalization to natural distribution shifts, TPT improves the zero-shot top-1 accuracy of CLIP by 3.6% on average, surpassing previous prompt tuning approaches that require additional task-specific training data. In evaluating cross-dataset generalization with unseen categories, TPT performs on par with the state-of-the-art approaches that use additional training data. Project page: https://azshue.github.io/TPT.

In critical applications, it is vital for classifiers to defer decision-making to humans. We propose a post-hoc method that makes existing classifiers selectively abstain from predicting certain samples. Our abstaining classifier is incentivized to maintain the original accuracy for each sub-population (i.e. no harm) while achieving a set of group fairness definitions to a user specified degree. To this end, we design an Integer Programming (IP) procedure that assigns abstention decisions for each training sample to satisfy a set of constraints. To generalize the abstaining decisions to test samples, we then train a surrogate model to learn the abstaining decisions based on the IP solutions in an end-to-end manner. We analyze the feasibility of the IP procedure to determine the possible abstention rate for different levels of unfairness tolerance and accuracy constraint for achieving no harm. To the best of our knowledge, this work is the first to identify the theoretical relationships between the constraint parameters and the required abstention rate. Our theoretical results are important since a high abstention rate is often infeasible in practice due to a lack of human resources. Our framework outperforms existing methods in terms of fairness disparity without sacrificing accuracy at similar abstention rates.

Large language models (LLMs) often fail to ask effective questions under uncertainty, making them unreliable in domains where proactive information-gathering is essential for decisionmaking. We present ALFA, a framework that improves LLM question-asking by (i) decomposing the notion of a "good" question into a set of theory-grounded attributes (e.g., clarity, relevance), (ii) controllably synthesizing attribute-specific question variations, and (iii) aligning models via preference-based optimization to explicitly learn to ask better questions along these fine-grained attributes. Focusing on clinical reasoning as a case study, we introduce the MediQ-AskDocs dataset, composed of 17k real-world clinical interactions augmented with 80k attribute-specific preference pairs of follow-up questions, as well as a novel expert-annotated interactive healthcare QA task to evaluate question-asking abilities. Models aligned with ALFA reduce diagnostic errors by 56.6% on MediQ-AskDocs compared to SOTA instruction-tuned LLMs, with a question-level win-rate of 64.4% and strong generalizability. Our findings suggest that explicitly guiding question-asking with structured, fine-grained attributes offers a scalable path to improve LLMs, especially in expert application domains.

Reliable generalization lies at the heart of safe ML and AI. However, understanding when and how neural networks generalize remains one of the most important unsolved problems in the field. In this work, we conduct an extensive empirical study (20'910 models, 15 tasks) to investigate whether insights from the theory of computation can predict the limits of neural network generalization in practice. We demonstrate that grouping tasks according to the Chomsky hierarchy allows us to forecast whether certain architectures will be able to generalize to out-of-distribution inputs. This includes negative results where even extensive amounts of data and training time never lead to any non-trivial generalization, despite models having sufficient capacity to fit the training data perfectly. Our results show that, for our subset of tasks, RNNs and Transformers fail to generalize on non-regular tasks, LSTMs can solve regular and counter-language tasks, and only networks augmented with structured memory (such as a stack or memory tape) can successfully generalize on context-free and context-sensitive tasks.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

Large language models like ChatGPT have shown substantial progress in natural language understanding and generation, proving valuable across various disciplines, including the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks which often require multi-task learning capabilities. Previous approaches, although beneficial, fall short in real-world applications because they necessitate task-specific annotations at inference time, limiting broader generalization. This paper introduces MING-MOE, a novel Mixture-of-Expert~(MOE)-based medical large language model designed to manage diverse and complex medical tasks without requiring task-specific annotations, thus enhancing its usability across extensive datasets. MING-MOE employs a Mixture of Low-Rank Adaptation (MoLoRA) technique, allowing for efficient parameter usage by maintaining base model parameters static while adapting through a minimal set of trainable parameters. We demonstrate that MING-MOE achieves state-of-the-art (SOTA) performance on over 20 medical tasks, illustrating a significant improvement over existing models. This approach not only extends the capabilities of medical language models but also improves inference efficiency.

Overparametrization often helps improve the generalization performance. This paper proposes a dual view of overparametrization suggesting that downsampling may also help generalize. Motivated by this dual view, we characterize two out-of-sample prediction risks of the sketched ridgeless least square estimator in the proportional regime masymp n asymp p, where m is the sketching size, n the sample size, and p the feature dimensionality. Our results reveal the statistical role of downsampling. Specifically, downsampling does not always hurt the generalization performance, and may actually help improve it in some cases. We identify the optimal sketching sizes that minimize the out-of-sample prediction risks, and find that the optimally sketched estimator has stabler risk curves that eliminates the peaks of those for the full-sample estimator. We then propose a practical procedure to empirically identify the optimal sketching size. Finally, we extend our results to cover central limit theorems and misspecified models. Numerical studies strongly support our theory.

Distribution shift presents a significant challenge in machine learning, where models often underperform during the test stage when faced with a different distribution than the one they were trained on. This paper focuses on domain shifts, which occur when the model is applied to new domains that are different from the ones it was trained on, and propose a new approach called D^3G. Unlike previous methods that aim to learn a single model that is domain invariant, D^3G leverages domain similarities based on domain metadata to learn domain-specific models. Concretely, D^3G learns a set of training-domain-specific functions during the training stage and reweights them based on domain relations during the test stage. These domain relations can be directly obtained and learned from domain metadata. Under mild assumptions, we theoretically prove that using domain relations to reweight training-domain-specific functions achieves stronger out-of-domain generalization compared to the conventional averaging approach. Empirically, we evaluate the effectiveness of D^3G using real-world datasets for tasks such as temperature regression, land use classification, and molecule-protein binding affinity prediction. Our results show that D^3G consistently outperforms state-of-the-art methods.

Humans (e.g., crowdworkers) have a remarkable ability in solving different tasks, by simply reading textual instructions that define them and looking at a few examples. Despite the success of the conventional supervised learning on individual datasets, such models often struggle with generalization across tasks (e.g., a question-answering system cannot solve classification tasks). A long-standing challenge in AI is to build a model that learns a new task by understanding the human-readable instructions that define it. To study this, we introduce NATURAL INSTRUCTIONS, a dataset of 61 distinct tasks, their human-authored instructions, and 193k task instances (input-output pairs). The instructions are obtained from crowdsourcing instructions used to create existing NLP datasets and mapped to a unified schema. Using this meta-dataset, we measure cross-task generalization by training models on seen tasks and measuring generalization to the remaining unseen ones. We adopt generative pre-trained language models to encode task-specific instructions along with input and generate task output. Our results indicate that models benefit from instructions when evaluated in terms of generalization to unseen tasks (19% better for models utilizing instructions). These models, however, are far behind an estimated performance upperbound indicating significant room for more progress in this direction.

Large Language Models trained on web-scale text acquire language generation abilities that can solve a wide range of tasks, particularly when task knowledge is refined into the generative prior using in-context examples. However, spurious features learned from noisy data hinder their generalizability. Supervised finetuning can introduce task specificity, but introduce data inefficiency. Prior studies indicate that (i) noisy neural circuitries coexist with generalizable ones within LLMs, and (ii) finetuning typically enhances (or suppresses) existing abilities without introducing newer ones. Building upon these, we propose TaRot, a novel method for task adaptation. TaRot intervenes in the neural circuitries using learnable rotation matrices that are optimized using Bayesian Optimization, on labelled samples in the order of standard few-shot prompting examples. Experiments on multiple classification and generation tasks using LLMs of varying sizes reveal the efficacy of TaRot, improving upon both zero- as well as few-shot performance, with average improvements (across models and tasks) of 23.81% and 11.15%, respectively. The source code is available at https://github.com/joykirat18/TaRot

OpenAI's recent introduction of Reinforcement Fine-Tuning (RFT) showcases the potential of reasoning foundation model and offers a new paradigm for fine-tuning beyond simple pattern imitation. This technical report presents OpenRFT, our attempt to fine-tune generalist reasoning models for domain-specific tasks under the same settings as RFT. OpenRFT addresses two key challenges of lacking reasoning step data and the limited quantity of training samples, by leveraging the domain-specific samples in three ways: question augmentation, synthesizing reasoning-process data, and few-shot ICL. The evaluation is conducted on SciKnowEval, where OpenRFT achieves notable performance gains with only 100 domain-specific samples for each task. More experimental results will be updated continuously in later versions. Source codes, datasets, and models are disclosed at: https://github.com/ADaM-BJTU/OpenRFT

Although recent advances in scaling large language models (LLMs) have resulted in improvements on many NLP tasks, it remains unclear whether these models trained primarily with general web text are the right tool in highly specialized, safety critical domains such as clinical text. Recent results have suggested that LLMs encode a surprising amount of medical knowledge. This raises an important question regarding the utility of smaller domain-specific language models. With the success of general-domain LLMs, is there still a need for specialized clinical models? To investigate this question, we conduct an extensive empirical analysis of 12 language models, ranging from 220M to 175B parameters, measuring their performance on 3 different clinical tasks that test their ability to parse and reason over electronic health records. As part of our experiments, we train T5-Base and T5-Large models from scratch on clinical notes from MIMIC III and IV to directly investigate the efficiency of clinical tokens. We show that relatively small specialized clinical models substantially outperform all in-context learning approaches, even when finetuned on limited annotated data. Further, we find that pretraining on clinical tokens allows for smaller, more parameter-efficient models that either match or outperform much larger language models trained on general text. We release the code and the models used under the PhysioNet Credentialed Health Data license and data use agreement.

Electronic health record (EHR) systems are used extensively throughout the healthcare domain. However, data interchangeability between EHR systems is limited due to the use of different coding standards across systems. Existing methods of mapping coding standards based on manual human experts mapping, dictionary mapping, symbolic NLP and classification are unscalable and cannot accommodate large scale EHR datasets. In this work, we present Text2Node, a cross-domain mapping system capable of mapping medical phrases to concepts in a large taxonomy (such as SNOMED CT). The system is designed to generalize from a limited set of training samples and map phrases to elements of the taxonomy that are not covered by training data. As a result, our system is scalable, robust to wording variants between coding systems and can output highly relevant concepts when no exact concept exists in the target taxonomy. Text2Node operates in three main stages: first, the lexicon is mapped to word embeddings; second, the taxonomy is vectorized using node embeddings; and finally, the mapping function is trained to connect the two embedding spaces. We compared multiple algorithms and architectures for each stage of the training, including GloVe and FastText word embeddings, CNN and Bi-LSTM mapping functions, and node2vec for node embeddings. We confirmed the robustness and generalisation properties of Text2Node by mapping ICD-9-CM Diagnosis phrases to SNOMED CT and by zero-shot training at comparable accuracy. This system is a novel methodological contribution to the task of normalizing and linking phrases to a taxonomy, advancing data interchangeability in healthcare. When applied, the system can use electronic health records to generate an embedding that incorporates taxonomical medical knowledge to improve clinical predictive models.

Generative large language models (LLMs) have shown great success in various applications, including question-answering (QA) and dialogue systems. However, in specialized domains like traditional Chinese medical QA, these models may perform unsatisfactorily without fine-tuning on domain-specific datasets. To address this, we introduce MedChatZH, a dialogue model designed specifically for traditional Chinese medical QA. Our model is pre-trained on Chinese traditional medical books and fine-tuned with a carefully curated medical instruction dataset. It outperforms several solid baselines on a real-world medical dialogue dataset. We release our model, code, and dataset on https://github.com/tyang816/MedChatZH to facilitate further research in the domain of traditional Chinese medicine and LLMs.

Accurate and efficient question-answering systems are essential for delivering high-quality patient care in the medical field. While Large Language Models (LLMs) have made remarkable strides across various domains, they continue to face significant challenges in medical question answering, particularly in understanding domain-specific terminologies and performing complex reasoning. These limitations undermine their effectiveness in critical medical applications. To address these issues, we propose a novel approach incorporating similar case generation within a multi-agent medical question-answering (MedQA) system. Specifically, we leverage the Llama3.1:70B model, a state-of-the-art LLM, in a multi-agent architecture to enhance performance on the MedQA dataset using zero-shot learning. Our method capitalizes on the model's inherent medical knowledge and reasoning capabilities, eliminating the need for additional training data. Experimental results show substantial performance gains over existing benchmark models, with improvements of 7% in both accuracy and F1-score across various medical QA tasks. Furthermore, we examine the model's interpretability and reliability in addressing complex medical queries. This research not only offers a robust solution for medical question answering but also establishes a foundation for broader applications of LLMs in the medical domain.

Generalizing to out-of-distribution (OOD) data or unseen domain, termed OOD generalization, still lacks appropriate theoretical guarantees. Canonical OOD bounds focus on different distance measurements between source and target domains but fail to consider the optimization property of the learned model. As empirically shown in recent work, the sharpness of learned minima influences OOD generalization. To bridge this gap between optimization and OOD generalization, we study the effect of sharpness on how a model tolerates data change in domain shift which is usually captured by "robustness" in generalization. In this paper, we give a rigorous connection between sharpness and robustness, which gives better OOD guarantees for robust algorithms. It also provides a theoretical backing for "flat minima leads to better OOD generalization". Overall, we propose a sharpness-based OOD generalization bound by taking robustness into consideration, resulting in a tighter bound than non-robust guarantees. Our findings are supported by the experiments on a ridge regression model, as well as the experiments on deep learning classification tasks.

In the expanding field of language model applications, medical knowledge representation remains a significant challenge due to the specialized nature of the domain. Large language models, such as GPT-4, obtain reasonable scores on medical question answering tasks, but smaller models are far behind. In this work, we introduce a method to improve the proficiency of a small language model in the medical domain by employing a two-fold approach. We first fine-tune the model on a corpus of medical textbooks. Then, we use GPT-4 to generate questions similar to the downstream task, prompted with textbook knowledge, and use them to fine-tune the model. Additionally, we introduce ECN-QA, a novel medical question answering dataset containing ``progressive questions'' composed of related sequential questions. We show the benefits of our training strategy on this dataset. The study's findings highlight the potential of small language models in the medical domain when appropriately fine-tuned. The code and weights are available at https://github.com/raidium-med/MQG.

Post-training, particularly reinforcement learning (RL) using self-play-generated data, has become a new learning paradigm for large language models (LLMs). However, scaling RL to develop a general reasoner remains a research challenge, as existing methods focus on task-specific reasoning without adequately addressing generalization across a broader range of tasks. Moreover, unlike traditional RL with limited action space, LLMs operate in an infinite space, making it crucial to search for valuable and diverse strategies to solve problems effectively. To address this, we propose searching within the action space on high-level abstract plans to enhance model generalization and introduce Critical Plan Step Learning (CPL), comprising: 1) searching on plan, using Monte Carlo Tree Search (MCTS) to explore diverse plan steps in multi-step reasoning tasks, and 2) learning critical plan steps through Step-level Advantage Preference Optimization (Step-APO), which integrates advantage estimates for step preference obtained via MCTS into Direct Preference Optimization (DPO). This combination helps the model effectively learn critical plan steps, enhancing both reasoning capabilities and generalization. Experimental results demonstrate that our method, trained exclusively on GSM8K and MATH, not only significantly improves performance on GSM8K (+10.5%) and MATH (+6.5%), but also enhances out-of-domain reasoning benchmarks, such as HumanEval (+12.2%), GPQA (+8.6%), ARC-C (+4.0%), MMLU-STEM (+2.2%), and BBH (+1.8%).

Single domain generalization aims to learn a model from a single training domain (source domain) and apply it to multiple unseen test domains (target domains). Existing methods focus on expanding the distribution of the training domain to cover the target domains, but without estimating the domain shift between the source and target domains. In this paper, we propose a new learning paradigm, namely simulate-analyze-reduce, which first simulates the domain shift by building an auxiliary domain as the target domain, then learns to analyze the causes of domain shift, and finally learns to reduce the domain shift for model adaptation. Under this paradigm, we propose a meta-causal learning method to learn meta-knowledge, that is, how to infer the causes of domain shift between the auxiliary and source domains during training. We use the meta-knowledge to analyze the shift between the target and source domains during testing. Specifically, we perform multiple transformations on source data to generate the auxiliary domain, perform counterfactual inference to learn to discover the causal factors of the shift between the auxiliary and source domains, and incorporate the inferred causality into factor-aware domain alignments. Extensive experiments on several benchmarks of image classification show the effectiveness of our method.

Recent advancements in digital pathology have led to the development of numerous foundational models that utilize self-supervised learning on patches extracted from gigapixel whole slide images (WSIs). While this approach leverages vast amounts of unlabeled data, we have discovered a significant issue: features extracted from these self-supervised models tend to cluster by individual WSIs, a phenomenon we term WSI-specific feature collapse. This problem can potentially limit the model's generalization ability and performance on various downstream tasks. To address this issue, we introduce Stain Normalized Pathology Foundational Model, a novel foundational model trained on patches that have undergone stain normalization. Stain normalization helps reduce color variability arising from different laboratories and scanners, enabling the model to learn more consistent features. Stain Normalized Pathology Foundational Model is trained using 285,153,903 patches extracted from a total of 34,795 WSIs, combining data from The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) project. Our experiments demonstrate that Stain Normalized Pathology Foundational Model significantly mitigates the feature collapse problem, indicating that the model has learned more generalized features rather than overfitting to individual WSI characteristics. We compared Stain Normalized Pathology Foundational Model with state-of-the-art models across six downstream task datasets, and our results show that Stain Normalized Pathology Foundational Model achieves excellent performance relative to the number of WSIs used and the model's parameter count. This suggests that the application of stain normalization has substantially improved the model's efficiency and generalization capabilities.

In this work, we develop an open-source surgical simulation environment that includes a realistic model obtained by MRI-scanning a physical phantom, for the purpose of training and evaluating a Learning from Demonstration (LfD) algorithm for autonomous suturing. The LfD algorithm utilizes Dynamic Movement Primitives (DMP) and Locally Weighted Regression (LWR), but focuses on the needle trajectory, rather than the instruments, to obtain better generality with respect to needle grasps. We conduct a user study to collect multiple suturing demonstrations and perform a comprehensive analysis of the ability of the LfD algorithm to generalize from a demonstration at one location in one phantom to different locations in the same phantom and to a different phantom. Our results indicate good generalization, on the order of 91.5%, when learning from more experienced subjects, indicating the need to integrate skill assessment in the future.

Large language models (LLMs) have shown promise for generative and knowledge-intensive tasks including question-answering (QA) tasks. However, the practical deployment still faces challenges, notably the issue of "hallucination", where models generate plausible-sounding but unfaithful or nonsensical information. This issue becomes particularly critical in the medical domain due to the uncommon professional concepts and potential social risks involved. This paper analyses the phenomenon of hallucination in medical generative QA systems using widely adopted LLMs and datasets. Our investigation centers on the identification and comprehension of common problematic answers, with a specific emphasis on hallucination. To tackle this challenge, we present an interactive self-reflection methodology that incorporates knowledge acquisition and answer generation. Through this feedback process, our approach steadily enhances the factuality, consistency, and entailment of the generated answers. Consequently, we harness the interactivity and multitasking ability of LLMs and produce progressively more precise and accurate answers. Experimental results on both automatic and human evaluation demonstrate the superiority of our approach in hallucination reduction compared to baselines.