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Jun 5

LUMINA: Long-horizon Understanding for Multi-turn Interactive Agents

Large language models can perform well on many isolated tasks, yet they continue to struggle on multi-turn, long-horizon agentic problems that require skills such as planning, state tracking, and long context processing. In this work, we aim to better understand the relative importance of advancing these underlying capabilities for success on such tasks. We develop an oracle counterfactual framework for multi-turn problems that asks: how would an agent perform if it could leverage an oracle to perfectly perform a specific task? The change in the agent's performance due to this oracle assistance allows us to measure the criticality of such oracle skill in the future advancement of AI agents. We introduce a suite of procedurally generated, game-like tasks with tunable complexity. These controlled environments allow us to provide precise oracle interventions, such as perfect planning or flawless state tracking, and make it possible to isolate the contribution of each oracle without confounding effects present in real-world benchmarks. Our results show that while some interventions (e.g., planning) consistently improve performance across settings, the usefulness of other skills is dependent on the properties of the environment and language model. Our work sheds light on the challenges of multi-turn agentic environments to guide the future efforts in the development of AI agents and language models.

  • 6 authors
·
Jan 22

Increasing Diversity While Maintaining Accuracy: Text Data Generation with Large Language Models and Human Interventions

Large language models (LLMs) can be used to generate text data for training and evaluating other models. However, creating high-quality datasets with LLMs can be challenging. In this work, we explore human-AI partnerships to facilitate high diversity and accuracy in LLM-based text data generation. We first examine two approaches to diversify text generation: 1) logit suppression, which minimizes the generation of languages that have already been frequently generated, and 2) temperature sampling, which flattens the token sampling probability. We found that diversification approaches can increase data diversity but often at the cost of data accuracy (i.e., text and labels being appropriate for the target domain). To address this issue, we examined two human interventions, 1) label replacement (LR), correcting misaligned labels, and 2) out-of-scope filtering (OOSF), removing instances that are out of the user's domain of interest or to which no considered label applies. With oracle studies, we found that LR increases the absolute accuracy of models trained with diversified datasets by 14.4%. Moreover, we found that some models trained with data generated with LR interventions outperformed LLM-based few-shot classification. In contrast, OOSF was not effective in increasing model accuracy, implying the need for future work in human-in-the-loop text data generation.

  • 3 authors
·
Jun 7, 2023

Robust Reward Modeling via Causal Rubrics

Reward models (RMs) are fundamental to aligning Large Language Models (LLMs) via human feedback, yet they often suffer from reward hacking. They tend to latch on to superficial or spurious attributes, such as response length or formatting, mistaking these cues learned from correlations in training data for the true causal drivers of quality (e.g., factuality, relevance). This occurs because standard training objectives struggle to disentangle these factors, leading to brittle RMs and misaligned policies. We introduce Crome (Causally Robust Reward Modeling), a novel framework grounded in an explicit causal model designed to mitigate reward hacking. Crome employs the following synthetic targeted augmentations during training: (1) Causal Augmentations, which are pairs that differ along specific causal attributes, to enforce sensitivity along each causal attribute individually, and (2) Neutral Augmentations, which are tie-label pairs varying primarily in spurious attributes, to enforce invariance along spurious attributes. Notably, our augmentations are produced without any knowledge of spurious factors, via answer interventions only along causal rubrics, that are identified by querying an oracle LLM. Empirically, Crome significantly outperforms standard baselines on RewardBench, improving average accuracy by up to 5.4% and achieving gains of up to 13.2% and 7.2% in specific categories. The robustness of Crome is further testified by the consistent gains obtained in a Best-of-N inference setting across increasing N, across various benchmarks, including the popular RewardBench (covering chat, chat-hard, safety, and reasoning tasks), the safety-focused WildGuardTest, and the reasoning-specific GSM8k.

  • 12 authors
·
Jun 19, 2025 3

Contextual Bandits in Payment Processing: Non-uniform Exploration and Supervised Learning at Adyen

Uniform random exploration in decision-making systems supports off-policy learning via supervision but incurs high regret, making it impractical for many applications. Conversely, non-uniform exploration offers better immediate performance but lacks support for off-policy learning. Recent research suggests that regression oracles can bridge this gap by combining non-uniform exploration with supervised learning. In this paper, we analyze these approaches within a real-world industrial context at Adyen, a large global payments processor characterized by batch logged delayed feedback, short-term memory, and dynamic action spaces under the Empirical Risk Minimization (ERM) framework. Our analysis reveals that while regression oracles significantly improve performance, they introduce challenges due to rigid algorithmic assumptions. Specifically, we observe that as a policy improves, subsequent generations may perform worse due to shifts in the reward distribution and increased class imbalance in the training data. This degradation occurs de spite improvements in other aspects of the training data, leading to decreased performance in successive policy iterations. We further explore the long-term impact of regression oracles, identifying a potential "oscillation effect." This effect arises when regression oracles influence probability estimates and the realizability of subsequent policy models, leading to fluctuations in performance across iterations. Our findings highlight the need for more adaptable algorithms that can leverage the benefits of regression oracles without introducing instability in policy performance over time.

  • 2 authors
·
Nov 30, 2024

ORacle: Large Vision-Language Models for Knowledge-Guided Holistic OR Domain Modeling

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.

  • 4 authors
·
Apr 10, 2024

WebTestPilot: Agentic End-to-End Web Testing against Natural Language Specification by Inferring Oracles with Symbolized GUI Elements

Visual language model (VLM) agents show great promise in automating end-to-end (E2E) web testing against requirements in natural language. However, the probabilistic nature of language models can have inherent hallucinations. Therefore, given a detected inconsistency between the requirement and the web application, it is hard to distinguish whether it stems from the hallucination or a real application bug. Addressing this issue presents two core technical challenges: the implicit oracle inference challenge, where the agent must act as its own oracle to implicitly decide if the application's behavior is correct without guidance, and the probabilistic inference challenge, where an LLM's inconsistent reasoning undermines its trustworthiness as an oracle. Existing LLM-based approaches fail to capture such implicit oracles, either by treating any page navigation that doesn't crash as a success, or by checking each state in isolation, thus missing bugs dependent on context from prior steps. We introduce WebTestPilot, an LLM-based agent designed to address these challenges. WebTestPilot uses (1) a symbolization layer which detects and symbolizes critical GUI elements on the web application into symbols (i.e., variables) and (2) translates natural language specification into a sequence of steps, each of which is equipped with inferred pre- and post-conditions over the symbols as an oracle. This oracle captures data, temporal, and causal dependencies, enabling the validation of implicit requirements. To advance research in this area, we build a benchmark of bug-injected web apps for evaluating NL-to-E2E testing. The results show that WebTestPilot achieves a task completion rate of 99%, with 96% precision and 96% recall in bug detection, outperforming the best baseline (+70 precision, +27 recall). The agent generalizes across diverse natural language inputs and model scales.

  • 6 authors
·
Feb 11

Physics Is All You Need? A Case Study in Physicist-Supervised AI Development of Scientific Software

Are AI agents tools, co-authors, or researchers? We present a quantified case study (N=1): a physicist supervising an AI coding agent (Claude Code, Sonnet and Opus models) over 12 work days and 57 sessions to build CLAX-PT, a differentiable one-loop perturbation theory module in JAX. We documented and classified 15 supervision events by intervention level. The agent resolved ten autonomously by iterating against oracle tests. Two more by the physicist's domain knowledge. The three it could not -- all evaded oracle detection -- share a common property: the agent treated symptom reduction as root-cause resolution. It spent 33 of the 57 sessions adjusting coefficients within a code architecture that could not represent the target physics, and could not re-evaluate its CLASS-PT branch choice even when prompted to reconsider; only an injected physics concept (anisotropic BAO damping) triggered the redesign. Separately, the agent committed a calibrated correction that passed all oracle tests but corresponded to no quantity in the theory, predicting wrong values at any other cosmology. The fudge factor was caught and replaced within the same session. Three supervision practices proved critical for catching what oracle tests missed: testing at diverse parameter points beyond the fiducial calibration; shared changelogs that surfaced stalled exploration across sessions; and an explicit rule against unphysical numerical patches. In this case, supervision design, not model capability, determined whether the agent's output was trustworthy. Closing the gap would require agents that propose architectural alternatives rather than optimize within a given structure, and distinguish predictive adequacy from explanatory correctness -- capabilities not exhibited here, not obviously addressed by scaling alone. [Abridged.]

  • 1 authors
·
May 27

ORACLE: Optimizing Reasoning Abilities of Large Language Models via Constraint-Led Synthetic Data Elicitation

Training large language models (LLMs) with synthetic reasoning data has become a popular approach to enhancing their reasoning capabilities, while a key factor influencing the effectiveness of this paradigm is the quality of the generated multi-step reasoning data. To generate high-quality reasoning data, many recent methods generate synthetic reasoning paths and filter them based on final answer correctness, often overlooking flaws in intermediate reasoning steps. To enhance the verification of intermediate reasoning steps, prior work primarily resorts to code execution or symbolic reasoning engines. However, code-based validation is restricted to code or mathematical tasks, and reasoning engines require a well-structured and complete context. As a result, existing methods fail to function effectively in natural language reasoning tasks that involve ambiguous or incomplete contexts. In these tasks, synthetic data still lack reliable checks for verifying each reasoning step. To address this challenge, we introduce ORACLE, a structured data generation framework inspired by syllogistic reasoning. ORACLE integrates the generative strengths of LLMs with symbolic supervision: the LLM produces step-wise reasoning contexts, while a symbolic reasoning engine verifies the validity of each intermediate step. By employing a unified prompting template to elicit modular reasoning chains, ORACLE enables fine-grained, step-level validation, facilitating the construction of high-quality multi-step reasoning data. Across six logical, factual, and commonsense reasoning benchmarks, our ORACLE consistently outperforms strong baselines on multiple models.

  • 3 authors
·
Mar 21

OracleProto: A Reproducible Framework for Benchmarking LLM Native Forecasting via Knowledge Cutoff and Temporal Masking

Large language models are moving from static text generators toward real-world decision-support systems, where forecasting is a composite capability that links information gathering, evidence integration, situational judgment, and action-oriented decision making. This capability is in broad demand across finance, policy, industry, and scientific research, yet its evaluation remains difficult: live benchmarks evaluate forecasts before answers exist, making them the cleanest way to measure forecasting ability, but they expire once events resolve; retrospective benchmarks are reproducible, but they cannot reliably distinguish genuine forecasting from facts a model may have already learned during pretraining. Prompting models to "pretend not to know" cannot replace a genuine knowledge boundary. We propose OracleProto, a reproducible framework for evaluating LLM native forecasting capability. OracleProto reconstructs resolved events into time-bounded forecasting samples by combining model-cutoff-aligned sample admission, tool-level temporal masking, content-level leakage detection, discrete answer normalization, and hierarchical scoring. Instantiated on a FutureX-Past-derived dataset with six contemporary LLMs, OracleProto distinguishes forecasting quality, sampling stability, and cost efficiency under controlled information boundaries, while reducing residual leakage to the 1% level, an order of magnitude below tool-only temporal filtering. OracleProto turns LLM forecasting from one-off evaluation into an auditable, reusable, and trainable dataset-level capability, providing a unified interface for fair cross-model comparison and a controlled signal source for downstream SFT and RL. Code and data are available at https://github.com/MaYiding/OracleProto and https://huggingface.co/datasets/MaYiding/OracleProto.

  • 5 authors
·
May 4

EnterpriseOps-Gym: Environments and Evaluations for Stateful Agentic Planning and Tool Use in Enterprise Settings

Large language models are shifting from passive information providers to active agents intended for complex workflows. However, their deployment as reliable AI workers in enterprise is stalled by benchmarks that fail to capture the intricacies of professional environments, specifically, the need for long-horizon planning amidst persistent state changes and strict access protocols. In this work, we introduce EnterpriseOps-Gym, a benchmark designed to evaluate agentic planning in realistic enterprise settings. Specifically, EnterpriseOps-Gym features a containerized sandbox with 164 database tables and 512 functional tools to mimic real-world search friction. Within this environment, agents are evaluated on 1,150 expert-curated tasks across eight mission-critical verticals (including Customer Service, HR, and IT). Our evaluation of 14 frontier models reveals critical limitations in state-of-the-art models: the top-performing Claude Opus 4.5 achieves only 37.4% success. Further analysis shows that providing oracle human plans improves performance by 14-35 percentage points, pinpointing strategic reasoning as the primary bottleneck. Additionally, agents frequently fail to refuse infeasible tasks (best model achieves 53.9%), leading to unintended and potentially harmful side effects. Our findings underscore that current agents are not yet ready for autonomous enterprise deployment. More broadly, EnterpriseOps-Gym provides a concrete testbed to advance the robustness of agentic planning in professional workflows.

ServiceNow-AI ServiceNow-AI
·
Mar 13 4

Stemming Hallucination in Language Models Using a Licensing Oracle

Language models exhibit remarkable natural language generation capabilities but remain prone to hallucinations, generating factually incorrect information despite producing syntactically coherent responses. This study introduces the Licensing Oracle, an architectural solution designed to stem hallucinations in LMs by enforcing truth constraints through formal validation against structured knowledge graphs. Unlike statistical approaches that rely on data scaling or fine-tuning, the Licensing Oracle embeds a deterministic validation step into the model's generative process, ensuring that only factually accurate claims are made. We evaluated the effectiveness of the Licensing Oracle through experiments comparing it with several state-of-the-art methods, including baseline language model generation, fine-tuning for factual recall, fine-tuning for abstention behavior, and retrieval-augmented generation (RAG). Our results demonstrate that although RAG and fine-tuning improve performance, they fail to eliminate hallucinations. In contrast, the Licensing Oracle achieved perfect abstention precision (AP = 1.0) and zero false answers (FAR-NE = 0.0), ensuring that only valid claims were generated with 89.1% accuracy in factual responses. This work shows that architectural innovations, such as the Licensing Oracle, offer a necessary and sufficient solution for hallucinations in domains with structured knowledge representations, offering guarantees that statistical methods cannot match. Although the Licensing Oracle is specifically designed to address hallucinations in fact-based domains, its framework lays the groundwork for truth-constrained generation in future AI systems, providing a new path toward reliable, epistemically grounded models.

  • 2 authors
·
Nov 8, 2025 2

Causal Inference by String Diagram Surgery

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

  • 3 authors
·
Nov 20, 2018

SQL Query Engine: A Self-Healing LLM Pipeline for Natural Language to PostgreSQL Translation

We present SQL Query Engine, an open-source, self-hosted service that translates natural language questions into validated PostgreSQL queries through a two-stage LLM pipeline. The first stage performs automatic schema introspection and SQL generation; a multi-strategy response parser extracts SQL from any LLM output format (JSON, code blocks, or raw text) without requiring structured output APIs. The second stage executes the query against PostgreSQL and, upon failure or empty results, enters an iterative self-healing loop in which the LLM diagnoses the error using full SQLSTATE codes and PostgreSQL diagnostic messages. Two mechanisms prevent regressions: early-accept returns successful queries immediately without LLM re-evaluation, and best-result tracking preserves the best partial result across retries. Schema context is cached per session in Redis, progress events stream via Redis Pub/Sub and SSE, and an OpenAI-compatible /v1/chat/completions endpoint lets existing tools work without modification. All database connections are read-only at the driver level. We evaluate across five LLM backends on a synthetic benchmark (75 questions, three databases) where the self-healing loop yields up to +9.3pp accuracy gains with zero regressions on the best model (Llama 4 Scout 17B, 57.3%), and on BIRD (437 questions, 11 databases migrated from SQLite to PostgreSQL) where the full pipeline reaches 49.0% execution accuracy (GPT-OSS-120B, +4.6pp). Source code: https://github.com/codeadeel/sqlqueryengine.

  • 1 authors
·
Apr 14

CUE-R: Beyond the Final Answer in Retrieval-Augmented Generation

As language models shift from single-shot answer generation toward multi-step reasoning that retrieves and consumes evidence mid-inference, evaluating the role of individual retrieved items becomes more important. Existing RAG evaluation typically targets final-answer quality, citation faithfulness, or answer-level attribution, but none of these directly targets the intervention-based, per-evidence-item utility view we study here. We introduce CUE-R, a lightweight intervention-based framework for measuring per-evidence-item operational utility in single-shot RAG using shallow observable retrieval-use traces. CUE-R perturbs individual evidence items via REMOVE, REPLACE, and DUPLICATE operators, then measures changes along three utility axes (correctness, proxy-based grounding faithfulness, and confidence error) plus a trace-divergence signal. We also outline an operational evidence-role taxonomy for interpreting intervention outcomes. Experiments on HotpotQA and 2WikiMultihopQA with Qwen-3 8B and GPT-5.2 reveal a consistent pattern: REMOVE and REPLACE substantially harm correctness and grounding while producing large trace shifts, whereas DUPLICATE is often answer-redundant yet not fully behaviorally neutral. A zero-retrieval control confirms that these effects arise from degradation of meaningful retrieval. A two-support ablation further shows that multi-hop evidence items can interact non-additively: removing both supports harms performance far more than either single removal. Our results suggest that answer-only evaluation misses important evidence effects and that intervention-based utility analysis is a practical complement for RAG evaluation.

intuit Intuit
·
Apr 6 2

DoVer: Intervention-Driven Auto Debugging for LLM Multi-Agent Systems

Large language model (LLM)-based multi-agent systems are challenging to debug because failures often arise from long, branching interaction traces. The prevailing practice is to leverage LLMs for log-based failure localization, attributing errors to a specific agent and step. However, this paradigm has two key limitations: (i) log-only debugging lacks validation, producing untested hypotheses, and (ii) single-step or single-agent attribution is often ill-posed, as we find that multiple distinct interventions can independently repair the failed task. To address the first limitation, we introduce DoVer, an intervention-driven debugging framework, which augments hypothesis generation with active verification through targeted interventions (e.g., editing messages, altering plans). For the second limitation, rather than evaluating on attribution accuracy, we focus on measuring whether the system resolves the failure or makes quantifiable progress toward task success, reflecting a more outcome-oriented view of debugging. Within the Magnetic-One agent framework, on the datasets derived from GAIA and AssistantBench, DoVer flips 18-28% of failed trials into successes, achieves up to 16% milestone progress, and validates or refutes 30-60% of failure hypotheses. DoVer also performs effectively on a different dataset (GSMPlus) and agent framework (AG2), where it recovers 49% of failed trials. These results highlight intervention as a practical mechanism for improving reliability in agentic systems and open opportunities for more robust, scalable debugging methods for LLM-based multi-agent systems. Project website and code will be available at https://aka.ms/DoVer.

microsoft Microsoft
·
Dec 7, 2025 4

The Ethics of ChatGPT in Medicine and Healthcare: A Systematic Review on Large Language Models (LLMs)

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

  • 2 authors
·
Mar 21, 2024

Coping with Information Loss and the Use of Auxiliary Sources of Data: A Report from the NISS Ingram Olkin Forum Series on Unplanned Clinical Trial Disruptions

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

  • 12 authors
·
Jun 22, 2022

Effect-Transparent Governance for AI Workflow Architectures: Semantic Preservation, Expressive Minimality, and Decidability Boundaries

We present a machine-checked formalization of structurally governed AI workflow architectures and prove that effect-level governance can be imposed without reducing internal computational expressivity. Using Interaction Trees in Rocq 8.19, we define a governance operator G that mediates all effectful directives, including memory access, external calls, and oracle (LLM) queries. Our development compiles with 0 admitted lemmas and consists of 36 modules, ~12,000 lines of Rocq, and 454 theorems. We establishseven properties: (P1) governed Turing completeness, (P2) governed oracle expressivity, (P3) a decidability boundary in which governance predicates are total and closed under Boolean composition while semantic program properties remain non-trivial and undecidable by governance, (P4) goal preservation for permitted executions, (P5) expressive minimality of primitive capabilities (compute, memory, reasoning, external call, observability), (P6) subsumption asymmetry showing structural governance strictly subsumes content-level filtering, and (P7) semantic transparency: on all executions where governance permits, the governed interpretation is observationally equivalent (modulo governance-only events) to the ungoverned interpretation. Together, these results show that governance and computational expressivity are orthogonal dimensions: governance constrains the effect boundary of programs while remaining semantically transparent to internal computation.

  • 1 authors
·
May 4

Automating Intervention Discovery from Scientific Literature: A Progressive Ontology Prompting and Dual-LLM Framework

Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.

  • 8 authors
·
Aug 20, 2024

Hippocrates: An Open-Source Framework for Advancing Large Language Models in Healthcare

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

  • 7 authors
·
Apr 25, 2024

When AI Takes the Couch: Psychometric Jailbreaks Reveal Internal Conflict in Frontier Models

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

  • 5 authors
·
Dec 2, 2025 5

Spoken Dialogue System for Medical Prescription Acquisition on Smartphone: Development, Corpus and Evaluation

Hospital information systems (HIS) have become an essential part of healthcare institutions and now incorporate prescribing support software. Prescription support software allows for structured information capture, which improves the safety, appropriateness and efficiency of prescriptions and reduces the number of adverse drug events (ADEs). However, such a system increases the amount of time physicians spend at a computer entering information instead of providing medical care. In addition, any new visiting clinician must learn to manage complex interfaces since each HIS has its own interfaces. In this paper, we present a natural language interface for e-prescribing software in the form of a spoken dialogue system accessible on a smartphone. This system allows prescribers to record their prescriptions verbally, a form of interaction closer to their usual practice. The system extracts the formal representation of the prescription ready to be checked by the prescribing software and uses the dialogue to request mandatory information, correct errors or warn of particular situations. Since, to the best of our knowledge, there is no existing voice-based prescription dialogue system, we present the system developed in a low-resource environment, focusing on dialogue modeling, semantic extraction and data augmentation. The system was evaluated in the wild with 55 participants. This evaluation showed that our system has an average prescription time of 66.15 seconds for physicians and 35.64 seconds for other experts, and a task success rate of 76\% for physicians and 72\% for other experts. All evaluation data were recorded and annotated to form PxCorpus, the first spoken drug prescription corpus that has been made fully available to the community (https://doi.org/10.5281/zenodo.6524162).

  • 6 authors
·
Nov 6, 2023

Query Carefully: Detecting the Unanswerables in Text-to-SQL Tasks

Text-to-SQL systems allow non-SQL experts to interact with relational databases using natural language. However, their tendency to generate executable SQL for ambiguous, out-of-scope, or unanswerable queries introduces a hidden risk, as outputs may be misinterpreted as correct. This risk is especially serious in biomedical contexts, where precision is critical. We therefore present Query Carefully, a pipeline that integrates LLM-based SQL generation with explicit detection and handling of unanswerable inputs. Building on the OncoMX component of ScienceBenchmark, we construct OncoMX-NAQ (No-Answer Questions), a set of 80 no-answer questions spanning 8 categories (non-SQL, out-of-schema/domain, and multiple ambiguity types). Our approach employs llama3.3:70b with schema-aware prompts, explicit No-Answer Rules (NAR), and few-shot examples drawn from both answerable and unanswerable questions. We evaluate SQL exact match, result accuracy, and unanswerable-detection accuracy. On the OncoMX dev split, few-shot prompting with answerable examples increases result accuracy, and adding unanswerable examples does not degrade performance. On OncoMX-NAQ, balanced prompting achieves the highest unanswerable-detection accuracy (0.8), with near-perfect results for structurally defined categories (non-SQL, missing columns, out-of-domain) but persistent challenges for missing-value queries (0.5) and column ambiguity (0.3). A lightweight user interface surfaces interim SQL, execution results, and abstentions, supporting transparent and reliable text-to-SQL in biomedical applications.

  • 5 authors
·
Dec 19, 2025

From Synthesis to Clinical Assistance: A Strategy-Aware Agent Framework for Autism Intervention based on Real Clinical Dataset

The development of AI-assisted Early Intensive Behavioral Intervention (EIBI) for Autism Spectrum Disorder (ASD) is severely constrained by data scarcity. Furthermore, while Applied Behavior Analysis (ABA) serves as the gold standard for clinical intervention, general-purpose Large Language Models (LLMs) struggle to strictly adhere to its standardized procedures, often resulting in interactions that are linguistically fluent but strategically inconsistent. To address these challenges, we introduce ASDAgent, a strategy-aware framework designed to unify high-fidelity intervention dialogue synthesis and clinical decision support. ASDAgent incorporates two specialized components to solve distinct problems: (i) a DoctorAgent equipped with an Observe-Think-Act-Correct (O-T-A-C) reasoning loop, which resolves the issue of strategy collapse in LLMs by making ABA execution explicit and controllable; and (ii) a ChildAgent that utilizes probabilistic behavior modeling to mitigate data homogeneity, simulating diverse and non-deterministic ASD response patterns. Experiments demonstrate that dialogues generated by ASDAgent closely mirror the strategy distribution of human therapists (KL divergence: 0.083). In real autism intervention, ASDAgent achieves nearly 80\% strategic consistency with human experts. Moreover, we show that synthetic data produced by ASDAgent effectively distills professional clinical knowledge into small language models (SLMs), significantly enhancing their therapeutic capabilities.

  • 8 authors
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Apr 8

On Penalty Methods for Nonconvex Bilevel Optimization and First-Order Stochastic Approximation

In this work, we study first-order algorithms for solving Bilevel Optimization (BO) where the objective functions are smooth but possibly nonconvex in both levels and the variables are restricted to closed convex sets. As a first step, we study the landscape of BO through the lens of penalty methods, in which the upper- and lower-level objectives are combined in a weighted sum with penalty parameter sigma > 0. In particular, we establish a strong connection between the penalty function and the hyper-objective by explicitly characterizing the conditions under which the values and derivatives of the two must be O(sigma)-close. A by-product of our analysis is the explicit formula for the gradient of hyper-objective when the lower-level problem has multiple solutions under minimal conditions, which could be of independent interest. Next, viewing the penalty formulation as O(sigma)-approximation of the original BO, we propose first-order algorithms that find an epsilon-stationary solution by optimizing the penalty formulation with sigma = O(epsilon). When the perturbed lower-level problem uniformly satisfies the small-error proximal error-bound (EB) condition, we propose a first-order algorithm that converges to an epsilon-stationary point of the penalty function, using in total O(epsilon^{-3}) and O(epsilon^{-7}) accesses to first-order (stochastic) gradient oracles when the oracle is deterministic and oracles are noisy, respectively. Under an additional assumption on stochastic oracles, we show that the algorithm can be implemented in a fully {\it single-loop} manner, i.e., with O(1) samples per iteration, and achieves the improved oracle-complexity of O(epsilon^{-3}) and O(epsilon^{-5}), respectively.

  • 4 authors
·
Sep 4, 2023

Distilling Instruction-following Abilities of Large Language Models with Task-aware Curriculum Planning

The process of instruction tuning aligns pre-trained large language models (LLMs) with open-domain instructions and human-preferred responses. While several studies have explored autonomous approaches to distilling and annotating instructions from more powerful proprietary LLMs, such as ChatGPT, they often neglect the impact of task distributions and the varying difficulty of instructions of the training sets. This oversight can lead to imbalanced knowledge capabilities and poor generalization powers of small student LLMs. To address this challenge, we introduce Task-Aware Curriculum Planning for Instruction Refinement (TAPIR), a multi-round distillation framework with balanced task distributions and dynamic difficulty adjustment. This approach utilizes an oracle LLM to select instructions that are difficult for a student LLM to follow and distill instructions with balanced task distributions. By incorporating curriculum planning, our approach systematically escalates the difficulty levels, progressively enhancing the student LLM's capabilities. We rigorously evaluate TAPIR using two widely recognized benchmarks, including AlpacaEval 2.0 and MT-Bench. The empirical results demonstrate that the student LLMs, trained with our method and less training data, outperform larger instruction-tuned models and strong distillation baselines. The improvement is particularly notable in complex tasks, such as logical reasoning and code generation.

  • 4 authors
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May 22, 2024

Demystifying Large Language Models for Medicine: A Primer

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

  • 23 authors
·
Oct 24, 2024

Scalable Evaluation of Online Facilitation Strategies via Synthetic Simulation of Discussions

Limited large-scale evaluations exist for facilitation strategies of online discussions due to significant costs associated with human involvement. An effective solution is synthetic discussion simulations using Large Language Models (LLMs) to create initial pilot experiments. We propose a simple, generalizable, LLM-driven methodology to prototype the development of LLM facilitators, and produce high-quality synthetic data without human involvement. We use our methodology to test whether current facilitation strategies can improve the performance of LLM facilitators. We find that, while LLM facilitators significantly improve synthetic discussions, there is no evidence that the application of more elaborate facilitation strategies proposed in modern Social Science research lead to further improvements in discussion quality, compared to more basic approaches. Additionally, we find that small LLMs (such as Mistral Nemo 12B) can perform comparably to larger models (such as LLaMa 70B), and that special instructions must be used for instruction-tuned models to induce toxicity in synthetic discussions. We confirm that each component of our methodology contributes substantially to high quality data via an ablation study. We release an open-source framework, "SynDisco" (pip install syndisco), which implements our methodology. We also release the "Virtual Moderation Dataset" (https://paperswithcode.com/dataset/vmd), a large, publicly available dataset containing LLM-generated and LLM-annotated discussions using multiple open-source LLMs.

  • 3 authors
·
Mar 13, 2025

Improving Chain-of-Thought for Logical Reasoning via Attention-Aware Intervention

Modern logical reasoning with LLMs primarily relies on employing complex interactive frameworks that decompose the reasoning process into subtasks solved through carefully designed prompts or requiring external resources (e.g., symbolic solvers) to exploit their strong logical structures. While interactive approaches introduce additional overhead or depend on external components, which limit their scalability. In this work, we introduce a non-interactive, end-to-end framework for reasoning tasks, enabling reasoning to emerge within the model itself-improving generalization while preserving analyzability without any external resources. We show that introducing structural information into the few-shot prompt activates a subset of attention heads that patterns aligned with logical reasoning operators. Building on this insight, we propose Attention-Aware Intervention (AAI), an inference-time intervention method that reweights attention scores across selected heads identified by their logical patterns. AAI offers an efficient way to steer the model's reasoning toward leveraging prior knowledge through attention modulation. Extensive experiments show that AAI enhances logical reasoning performance across diverse benchmarks, and model architectures, while incurring negligible additional computational overhead. Code is available at https://github.com/phuongnm94/aai_for_logical_reasoning.

  • 3 authors
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Jan 23

When OpenClaw Meets Hospital: Toward an Agentic Operating System for Dynamic Clinical Workflows

Large language model (LLM) agents extend generative models with reasoning, tool use, and persistent memory, thereby enabling the automation of complex tasks. In healthcare, such systems could support documentation, care coordination, and clinical decision making. Their reliable deployment in hospitals, however, remains constrained by safety risks, limited transparency, and inadequate mechanisms for handling longitudinal clinical context. Here we propose an architecture that adapts LLM agents to hospital environments. The design comprises four components: a restricted execution environment inspired by multi-user operating systems, a document-centric interaction model linking patient and clinician agents, a page-indexed memory architecture for longitudinal context management, and a curated library of composable medical skills. Implemented on top of OpenClaw, an open-source agent orchestration framework, this design provides the basis for an Agentic Operating System for Hospitals: a computing layer for coordinating clinical workflows while preserving safety, transparency, and auditability. To evaluate the memory component, we introduce manifest-guided retrieval for hierarchical navigation of longitudinal patient records. In a benchmark derived from the MIMIC-IV dataset (v2.2) comprising 100 de-identified patient records and 300 clinical queries stratified across three difficulty tiers (100 per tier), manifest-guided retrieval matched a metadata-filtered RAG baseline on overall recall (0.877 versus 0.876) while achieving 2.2x higher precision (0.779 versus 0.352) and retrieving fewer documents; on tier-3 longitudinal queries, manifest recall was 21% higher (0.846 versus 0.701), confirming that LLM-guided hierarchical navigation is most valuable when queries span multiple care episodes. These results outline a practical path toward hospital-scale agentic infrastructure.

  • 8 authors
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Mar 20

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

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