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Latest papers 533

38 papers in the last four weeks, up 41% on the four weeks before. 0.3% of all new papers.

Jun 1, 2026eess.SP

Gravity-Aware Hierarchical Routing for Lightweight SensorLLM on Human Activity Recognition

Recent studies on sensor-language alignment have shown that two-stage frameworks can improve the semantic modeling ability of wearable-sensor human activity recognition (HAR), where SensorLLM-style methods first perform motion-to-language alignment and then fine-tune the model for downstream tasks. However, our experiments reveal a consistent failure mode when the Stage 2 backbone is compressed to a compact model such as TinyLlama: recognition of dynamic activities remains relatively strong, while the discrimination of low-motion static classes such as standing, sitting, and lying degrades substantially. To address this issue, we propose a gravity-aware hierarchical routing head as a lightweight post-alignment adaptation built on top of an already aligned model, rather than a new large-scale pretraining framework. The method uses the per-channel mean and std from the Chronos tokenizer state to extract statistical cues related to posture and gravity direction, and adaptively combines a static expert and a full expert through soft routing, together with a load-balancing loss for stable training. On the MHealth dataset, this design significantly improves macro-F1 with minimal parameter overhead, and the gains are concentrated mainly on static classes while preserving strong performance on dynamic activities. As a first arXiv disclosure, the current paper reports results on a single dataset only, with the goal of highlighting the core method and laying the groundwork for broader evaluation in future work.

Hao Li, Mingrui Zheng, Yasuyuki Tahara +1

Department of Informatics, Graduate School of Informatics and Engineering The University of Electro-Communications, Tokyo, Japan · Graduate School of Information Science and Technology Hokkaido University, Sapporo, Japan

Human Activity Recognition Healthcare Mixture of Experts

May 31, 2026cs.CV

Analysis of Ethnic Disparities in Autism Spectrum Disorder among Toddlers

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by challenges in communication and behavior. This study examines the relationship between ethnicity and ASD traits, along with behavioural scores, sex and neonatal jaundice across three ethnic groups: White Europeans, Asians, and Middle Eastern individuals. We perform a logistic regression and show that ethnicity has a significant effect on incidence of ASD. White Europeans are 81% increased risk of ASD and Middle Easterners are at 79% reduced risk of ASD compared to Asians. We also confirm earlier studied which show that neonatal jaundice is a significant predictor of ASD, while male children are at much higher risk of ASD compared to female children. These results suggest the need for diagnostic frameworks and interventions that account for ethnic in the presentation and assessment of ASD traits

Aadithya Prabha Ramaharsha, Deevna Reddy, Uma Ranjan

Sri Ramachandra Institute of Higher Education and Research

Healthcare Autism Spectrum Disorder

May 29, 2026cs.AI

FAM-Bench: A Multimodal Benchmark for Condition-Aware Food-as-Medicine Reasoning

Food-as-Medicine requires models to reason beyond what a dish is or what nutrition it contains: they must decide whether a concrete food choice is appropriate for a specific health condition. Existing food AI benchmarks primarily evaluate dish recognition, recipe understanding, nutrient estimation, or general nutrition question answering, leaving this health-aware decision layer largely untested. We introduce FAM-Bench, a multi-modal Food-as-Medicine benchmark with 2500 nutrition-expert-verified instances across 13 diet-related health conditions. The benchmark contains two complementary tasks: dish-level suitability assessment, where models judge whether a dish is suitable for a condition from its image and ingredient list, and comparative dish analysis, where models rank four candidate dishes by condition-specific suitability. Both tasks require integrating ingredient evidence, visual preparation cues, and clinical nutrition constraints, providing a standardized testbed for grounded health-aware reasoning in language and vision-language models.

Mingyang Mao, Bhargav Rishi Medisetti, Utkarsh Grover +4

Department of Electrical Engineering, University of South Florida · Muma College of Business, University of South Florida · Computer Science, University of Copenhagen

Healthcare Clinical Decision Support Multimodal Reasoning Multimodal Model Evaluation

May 29, 2026cs.HC

Developing an AI-Powered UX Research Point of View for Digital Health in A Regulatory Context: An Exemplar Case from MSM and Transgender HIV Care in Nigeria

User Experience Research (UXR) in a legal and regulatory contexts presents unique challenges that require specialised approaches to protect vulnerable populations whilst generating actionable insights. Digital consultation, appointment booking, and medication delivery platforms show promise for extending care access; however, their real-world effectiveness is curtailed by an absence of theoretically grounded user experience research (UXR) methodologies that adequately account for the psychosocial conditions of these populations. This paper introduces a Generative AI-augmented UXR methodology, grounded in the UXR Point of View (PoV) Playbook, to guide the design of psychologically safe, low-cognitive-load digital health interventions for MSM and transgender individuals living with HIV/AIDS in Nigeria. Drawing from empirical research involving co-design workshops, thematic analysis, and requirements engineering, the methodology is operationalised through a four-stage UXR process encompassing AI-supported hypothesis generation, foundational planning, insight generation via Building Blocks, and the construction of stakeholder-specific PoV narratives. This process results in ten theory-informed UXR Play Cards that translate psychological mechanisms and empirical findings into actionable design guidance. Each play contains actionable tasks, AI-augmented approaches, and ethical guardrails tailored for research with marginalised populations. The output is a set of ten theory-informed UXR Play Cards translating psychological insight and empirical evidence into actionable design guidance. The core contribution is a replicable, stigma-aware, and privacy-centred framework for responsible GenAI use in UXR practice, advancing human-centred digital health design for marginalised communities.

Emmanuel Oluwatosin Oluokun, Festus Fatai Adedoyin, Huseyin Dogan +5

School of Computing and Engineering, Bournemouth University Poole, UK

Healthcare Human-Centered AI Responsible AI

May 28, 2026cs.AI

EHRBench: An Automated and Reliable EHR-based Benchmark for Clinical Decision Making with LLMs

Clinical decision-making (CDM) is central to real-world clinical workflows, where clinicians infer diagnoses, select treatments, or anticipate future health outcomes under incomplete evidence. LLMs are increasingly used to support these decisions due to strong language capabilities, broad biomedical knowledge, and efficiency, yet the reliability of LLMs on real-world clinical decision tasks remains insufficiently understood. To evaluate CDM models, especially LLM-based models, an ideal and practical medical decision benchmark should be constructed via an automated yet reliable pipeline to ensure both scale and quality. Moreover, the grounding of a CDM benchmark in real patient EHRs can better support evaluation on practical CDM tasks that require substantive biomedical knowledge and clinical inference. To fill the gaps, we introduce EHRBench, an automated and reliable EHR-grounded benchmark for evaluating LLM-based clinical decision-making at scale. To ensure scalability and reliability, EHRBench is constructed through an EHR-LLM-KB(knowledge-base) interaction pipeline. For efficiency, we use a specialized LLM to automatically convert encounter-level EHR trajectories into structured templates and deterministically instantiate the templates into QA items. In parallel, we apply systematic KB-based verification and enrichment to filter hallucinated or ambiguous relations and to improve reliability. Using this pipeline, we construct nearly 1M (960,067) QA items spanning three core inference-required clinical decision tasks: diagnosis, treatment, and prognosis. We benchmark more than 30 representative LLMs on EHRBench and provide detailed analyses of performance and robustness. The results show consistent capability trends across settings, further validating the reliability of EHRBench and highlighting actionable gaps toward clinically reliable LLM systems.

Yuzhang Xie, Keqi Han, Yunpeng Xiao +7

Emory University Atlanta, GA, USA · Stanford University Stanford, CA, USA

Healthcare Clinical Decision-Making Clinical Language Model Evaluation Electronic Health Records

May 28, 2026cs.LG

AMNESIA: A Large Scale Medical Unlearning Benchmark Suite with Disease-Informed Analysis

Medical knowledge is continuously evolving. This creates a need to update or selectively forget information encoded in already-trained medical LLMs. Machine unlearning aims to remove the influence of specific training data from a model without full retraining. Yet, existing unlearning benchmarks rely on synthetic or small-scale general data, leaving clinical unlearning understudied. We introduce AMNESIA, the first large-scale, open source benchmark for medical unlearning, with 70,560 question-answer pairs from 8,820 patient notes across 11 disease categories. AMNESIA includes both factual questions testing direct recall and reasoning questions testing clinical inference. We use it to evaluate four widely used unlearning methods at both random patient and disease-level, and introduce a new metric for detecting leakage of medical terminology. We show that unlearning individual patients erodes knowledge of others with the same condition, calling for methods that can better separate patients from shared clinical knowledge.

Saeedeh Davoudi, Reihaneh Iranmanesh, Ophir Frieder +1

1IR Lab, Computer Science Department, Georgetown University, Washington D.C.

Healthcare Privacy Leakage in Language Models Clinical Language Model Evaluation Machine Unlearning LLM Unlearning Machine Unlearning Evaluation

May 28, 2026cs.LG

Counterfactual Evaluation Reveals Hidden Capability Profiles in Clinical LLMs and Agents

Two clinical AI systems can score nearly identically on coverage-based rubrics yet behave radically differently when their patient inputs change: one updates its recommendations to match the new clinical signal, while the other produces the same output regardless. We introduce the Causal Sensitivity Score (CSS), a pre-registered interventional metric that mutates oncology tumor-board cases along five clinically meaningful dimensions - biomarker flips, prior-treatment failures, biomarker removals, surgery-status changes, and stage perturbations - and scores whether each model updates its recommendations in the pre-registered correct direction using a {0, 0.5, 1.0} scale. Benchmarked against the Consensus Match Score (CMS), a coverage-based weighted recall metric, six frontier models from three labs evaluated in single-shot inference across 224 cases rank in nearly opposite orders: all six models change rank, the CMS-worst model becomes CSS-best, and one upper-mid CMS model ranks last on CSS. We further surface a universal safety blind spot: every frontier model fails on surgery-status interventions (at most 17.2% CSS on Family D), a finding CMS does not expose. The metric also transfers to tool-using agents: in a ReAct-style experiment, tool use improves CSS for five of six models (+2.5 to +20.3 percentage points), yet the lowest-CSS model retrieves the same chart sections and still fails to update its recommendations - revealing a structural responsiveness deficit visible only under counterfactual evaluation. Cross-judge replication and three-rater medical-professional validation confirm the aggregate findings. Interventional pre-registered metrics like CSS complement coverage-based evaluation for clinical AI agents: they capture responsiveness that coverage metrics miss and offer a candidate dense reward signal for future agentic RL systems.

Matt Turk

Protege Data Lab New York City, USA

Counterfactual Evaluation Healthcare Clinical Decision Support LLM Agent Evaluation Clinical Language Model Evaluation

May 28, 2026cs.CL

Generalistic or Specific Embeddings, Which is Better? An Empirical Study on Search for Clinical Coding in Non-English Languages

Sentence-embedding models for semantic search are overwhelmingly developed and evaluated on English corpora. When applied to clinical retrieval in other languages -- particularly retrieval of ICD-10-CM / CIE-10 codes -- recall degrades in ways often masked by aggregate benchmarks. We study whether large generative language models can serve as data factories to close this gap. We build a two-stage retriever (bi-encoder followed by cross-encoder reranker), fine-tuned from a Spanish biomedical encoder (PlanTL-GOB-ES/bsc-bio-ehr-es) on Gemini-generated synthetic data covering English, Spanish, Catalan, Italian, Portuguese and French, and evaluate against BioBERT-ST and the un-tuned Spanish encoder. The bi-encoder alone matches BioBERT-ST on MRR (0.876 vs. 0.866) and overtakes it on R@3 (0.650 vs. 0.626) and R@5 (0.804 vs. 0.790) without English biomedical pretraining. Adding a cross-encoder reranker lifts aggregate R@5 to 0.822 and dominates on four of five languages (+0.017 Spanish, +0.033 Catalan, +0.018 French, +0.037 Portuguese) at the cost of a small English regression. The trade-off is clinically acceptable: Portuguese reaches R@5 = 0.829 vs. BioBERT-ST's 0.714. Contributions: an open recipe for building domain-specific medical retrievers from LLM-generated data; quantification of the learning gain (MRR 0.755 to 0.876, +15.9% with ~19,500 synthetic pairs); and a characterisation of where gains concentrate by language and rank.

David Rey-Blanco, Roberto Cruz

TietAI

Data Augmentation Healthcare Multilingual IR Biomedical IR Text Embedding Models

May 28, 2026cs.CL

MedCase-Structured: A Text-to-FHIR Dataset for Benchmarking Diagnostic Reasoning in Clinically Realistic EHR Settings

Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited. Existing benchmarks often rely on static datasets or unstructured inputs that do not reflect the interoperable data formats used in clinical systems. We introduce a reusable pipeline for generating terminology-grounded HL7 FHIR R4 bundles from unstructured text, enabling controllable evaluation of clinical decision support systems over structured inputs. The pipeline combines staged LLM generation with terminology-grounded validation and repair to eliminate hallucinated codes and enforce structural and semantic consistency. Applying this approach to MedCaseReasoning, we construct MedCase-Structured, a synthetic dataset of 1,732 FHIR bundles derived from clinician-authored diagnostic cases, producing complete, valid bundles for 97.1% of attempted cases. Evaluation on MedCase-Structured reveals consistently lower diagnostic accuracy for LLMs on structured FHIR inputs than with plain text, highlighting the importance of deployment-aligned benchmarking.

Valentina Bui Muti, Eugénie Dulout, Ziquan Fu

System Inc., New York, NY, USA.

Healthcare Clinical Decision Support Synthetic Benchmark Generation Clinical Reasoning Clinical Language Model Evaluation Electronic Health Records

May 28, 2026cs.CL

CCS: Clinical Consensus Selection for Radiology Report Generation

Radiology report generation (RRG) is commonly formulated as a single-path generation task, where a multimodal large language model (MLLM) produces one decoded report as the final output. While recent progress has largely been driven by scaling training data, model capacity, and retrieval mechanisms, improving report quality at inference time remains underexplored. In this work, we observe that fixed radiology MLLMs often generate clinically stronger reports elsewhere in their candidate pool than the one selected by default decoding, suggesting that inference-time decision making remains an overlooked bottleneck. To address this, we propose Clinical Consensus Selection (CCS), a decoder-agnostic inference-time selection framework that samples multiple candidate reports and selects the one with the highest clinical consensus across the rollout pool. CCS unifies text-based utilities with a radiology-adapted utility computed by an image--report-trained multimodal embedder, which measures candidate agreement beyond surface-level textual similarity. Across three datasets and multiple radiology MLLMs, CCS consistently improves inference-time performance over single-path decoding and generic Best-of-N baselines, with particularly clear gains on clinical metrics. Further analysis shows that image-grounded utility forms a selection axis distinct from textual consensus and that substantial headroom remains for improving RRG at inference time.

Xi Zhang, Yingshu Li, Zaiqiao Meng +2

School of Computing Science, University of Glasgow · School of Electrical and Computer Engineering, University of Sydney · Language Technology Lab, University of Cambridge

Radiology Report Generation Radiology VLMs Healthcare Multimodal Reranking Best-of-N Sampling

May 28, 2026cs.CV

Genetically Aligned Patient Representations Improve Hematological Diagnosis

Multimodal alignment of histopathology encoders with transcriptomic and genomic data has been shown to significantly improve performance in downstream diagnostic tasks. Hematological cytology is unique in that visual single-cell evaluation is often paired with cytogenetics and molecular genetics for blood cancer diagnosis. In this study, we present a framework to align single white blood cell images with chromosomal aberrations (karyotype) and somatic mutations from targeted gene panels. Our training strategy follows a two-stage approach: (i) self-supervised, vision-only pretraining of a transformer aggregator using an iBOT head on a cohort of over 1500 patients, and (ii) genetic alignment via supervised contrastive loss on acute myeloid leukemia patients. Our genetically aligned patient encoder improves hematological diagnostic tasks, outperforming slide-level histopathology foundation models. Additionally, the model provides off-the-shelf retrieval capabilities for diseases and genetic alterations. Incorporating genetic data into patient encoders increases the quality of patient representations, providing a framework that aligns with clinical diagnostic workflows and paves the way for future multimodal hematology-specific AI. The code and model weights are available at https://github.com/marrlab/GenBloom.

Muhammed Furkan Dasdelen, Fatih Ozlugedik, Ilaria Looser +3

Institute of AI for Health, Helmholtz Munich, Germany · International School of Medicine, Istanbul Medipol University, Türkiye · Munich Leukemia Laboratory, Germany +4

Computational Pathology Healthcare Medical Diagnosis Cross-Modal Alignment Oncology Medical Image Representation Learning

May 28, 2026cs.CL

Internal Representation, Not Clinical Knowledge: Where Apparent LLM Triage Failures Originate

Patient-voiced clinical-triage benchmarks report high under-triage rates for consumer LLMs for constrained multiple-choice output, yet the same cases score differently with free-text. We ask whether output format changes the model's \emph{clinical representation} or only the mapping from a preserved representation to an answer. Using sparse-autoencoder (SAE) features in Gemma 3 4B/12B IT and Qwen3-8B, we find the same medical features fire on the shared clinical narrative under both formats but go {silent} at the multiple-choice decision token in all the cases at every model. Three independent methods (natural-language autoencoder verbalization, decision-token logit attribution, and top-feature characterization) agree that scaffold and format features, but not medical features, drive the decision logits. Behaviorally, the multiple-choice penalty inverts under both structured and natural-language input, option-order shuffle rules out positional bias, and the gap is dominated by off-by-one decision (the model picks an adjacent acuity letter to the gold answer) rather than knowledge failure. Thus, the failure originates in the output format and not in the clinical representation.

David Fraile Navarro, Berardino Como, Jialei Sheng +2

Macquarie University, Sydney, Australia · Politecnico di Bari, Bari, Italy · NSW Health, Sydney, Australia +1

Healthcare Clinical Triage LLM Interpretability Clinical Decision Support Clinical Language Model Evaluation

May 28, 2026cs.AI

Why Specialist Models Still Matter: A Heterogeneous Multi-Agent Paradigm for Medical Artificial Intelligence

The impressive performance of generalist large language models (LLMs) such as GPT and Claude in healthcare raises a critical question: will domain-specific medical specialist models become obsolete? We argue that the future of medical artificial intelligence (AI) lies not in building monolithic medical foundation models, nor in replacing human expertise, but in orchestrating collaboration among generalist LLMs, domain-specific specialist models, and clinicians. We propose HetMedAgent, a heterogeneous medical multi-agent framework that enables conflict-aware evidence fusion, uncertainty-based clinician intervention triggering, and adaptive threshold calibration. Experiments on three real-world clinical decision-making tasks demonstrate that the synergy between generalist LLMs and domain-specific specialist models significantly outperforms using either type of model alone, validating the irreplaceable value of specialist models in modality-specific analysis. HetMedAgent represents a shift from building medical LLMs or foundation models to multi-agent collaboration, achieving a balance between general reasoning capabilities and domain-specific precision.

Yanan Wang, Shuaicong Hu, Jian Liu +3

Department of Biomedical Engineering, College of Biomedical Engineering, Fudan University, Shanghai 200433, China · Department of Cardiology, Xinghua City People’s Hospital affiliated to Yangzhou University, Jiangsu 225700, China.

Multi-Agent LLM Systems Healthcare Clinical Decision Support Multi-Agent Collaboration Human-AI Collaboration Medical LLMs

May 28, 2026cs.AI

Think Fast, Talk Smart: Partitioning Deterministic and Neural Computation for Structured Health Text Generation

Large language models (LLMs) are increasingly being used to generate health text from structured records such as wearable time series, biomarkers, vitals, and care-management logs. For recurring health outputs, fluency is not enough: systems must remain faithful to source data, ground explanatory claims in available evidence, follow stated policies, emit machine-readable outputs, and run cheaply enough for repeated use. We ask which responsibilities in structured health generation should be deterministic computation rather than runtime LLM prompting. We introduce Think Fast, Talk Smart, a sleep-health insight pipeline in which deterministic code performs recurring analysis before one bounded LLM writer call. Across 280 user-nights and six models, achieves lower numeric error, lower instruction-compliance error, and lower end-to-end cost than structured zero-shot and few-shot one-call baselines. Layer replacement reveals contract-specific failures: LLM comparison raises numeric error, LLM ranking degrades policy selection, LLM attribution increases unsupported causal language, and an LLM-generated writer interface reintroduces errors even after upstream facts are deterministic. The results support a broader design rule: let code own recurring analysis, and let LLMs express verified facts within bounded interfaces.

Kai-Chen Cheng, Haejun Han, David Q. Sun

Healthcare Neuro-Symbolic AI Medical LLMs Text Generation

May 28, 2026cs.HC

Inform, Coach, Relate, Listen: Auditing LLM Caregiving Support Roles

Language models are increasingly being deployed for conversational support in informal caregiving contexts, where interactions often extend beyond information-seeking: caregivers seek emotional reassurance, guidance, and help, while navigating uncertain, relationally complex care decisions. Yet most safety evaluations assess model behavior under generic prompts, leaving a critical question unexamined: does a model's safety profile change with its support role? We study this by operationalizing four expert-reviewed support roles grounded in social support theory: Inform, Coach, Relate, and Listen, and comparing them against two baseline controls: a basic prompting condition and a retrieval-augmented generation (RAG) condition. We evaluate across three language models (GPT-4o-mini, Llama-3.1-8B-Instruct, and MedGemma-1.5-4b-it) on 5,000 real-world queries from online Alzheimer's Disease and Related Dementias (ADRD) communities. We find that the LLM's support role systematically shapes both the prevalence and composition of interactional risks. Furthermore, a human evaluation study reveals a perceived quality--safety tension: more directive, information-oriented roles are rated as more helpful and trustworthy despite exhibiting elevated interactional risk profiles. We release ~90,000 support role-conditioned model responses with risk annotations as an ecologically grounded resource for research on safer LLM-mediated conversational support.

Drishti Goel, Agam Goyal, Veda Duddu +8

University of Illinois Urbana-Champaign · University of Massachusetts Amherst · OSF HealthCare +1

Healthcare LLM Auditing LLM Safety LLM Safety Evaluation

May 28, 2026cs.LG

SigmaMedStat: Temporal Signal Modeling for ICU False Alarm Reduction

Alarm fatigue in intensive care units (ICUs) is a well documented patient safety crisis. Clinical monitors generate 350 or more alarms per patient per day, out of which 72-99% are clinically irrelevant. Staff desensitization to non-actionable alarms increases the risk of missed true emergencies. This paper presents SigmaMedStat, a machine learning system that evaluates the trustworthiness of physiological alarm signals before clinical action is taken. Four approaches were evaluated on the PhysioNet/Computing in Cardiology Challenge 2015 dataset of 498 four-channel ICU alarm recordings. Primary contribution is a temporal modeling framework that splits each 60 second recording into six consecutive 10-second chunks, and this in turn generates Continuous Wavelet Transform (CWT) scalograms per chunk, encodes each chunk with a shared EfficientNet-B0 encoder, and passes the resulting feature sequence to a two-layer Long Short-Term Memory (LSTM) network. Five-fold stratified cross-validation yields a mean AUC of 0.822 +/- 0.016 (95% CI: [0.790,0.853]), compared to 0.641 for a static EfficientNet baseline trained on the full 60-second window. Ablation studies confirm that temporal chunking and multi-channel signal fusion both contribute independently to classification performance. Per-alarm type analysis reveals that Ventricular Flutter is the most accurately classified alarm type (AUC 0.820) while Asystole remains the hardest (AUC 0.722). Error analysis identifies 65 false negatives and 85 high-confidence misclassifications as the primary failure modes. All code and results are publicly available at https://github.com/Arun-K-Ram/sigmamedstat.

Arunkumar Ramachandran

Healthcare Time Series Classification Anomaly Detection

May 27, 2026cs.CL

SafeRx-Agent: A Knowledge-Grounded Multi-Agent Framework for Safe and Explainable Medication Recommendation

Medication recommendation predicts medications for patient visits, but existing methods still face two key challenges. At the model level, traditional drug recommendation methods only predict structured drug codes with limited evidence grounding, while LLM agents can use richer clinical context but may lack safety verification and traceability. At the task level, existing benchmarks often use broad medication categories, which ignore subgroup-level safety differences and can lead to risk overestimation. We introduce the first fine-grained medication recommendation setting based on fourth-level ATC code generation. We propose Safe Prescription Agent (SafeRx-Agent), a knowledge-grounded multi-agent framework that uses patient context, external clinical knowledge, and safety verification to recommend traceable medication sets. Experimental results on MIMIC-III and MIMIC-IV datasets show that SafeRx-Agent improves fine-grained medication prediction accuracy while controlling drug interactions, contraindications, and medication set size.

Xinyu Wang, Hanwei Wu, Zhenghan Tai +7

McGill University · McMaster University · University of Toronto +1

Multi-Agent LLM Systems Healthcare Clinical Decision Support LLM Agent Safety

May 27, 2026cs.AI

Trends in AI and Human-AI Interaction in Clinical Trials -- A Hybrid Human-AI Exploration

This paper examines records retrieved from the ClinicalTrials.gov registry to characterize temporal trends in AI terminology and the geographical distribution of AI trials. The work also reports on an exploratory hybrid human-AI approach to analyzing human-AI interaction trends in registered clinical trials. The hybrid workflow comprised a frontier generative AI model (GPT-5.5) and human review to screen and categorize records returned by an AI-focused search. The findings indicate a marked increase in AI-related trials over time, with recent growth in references to machine learning, deep learning, chatbots, GPTs, and large language models. Geographically, China and the United States accounted for the largest numbers of AI-related trials, with notable recent increases in several other countries including Italy, France, Spain, the UK and Turkey (Türkiye). In a random sample of 100 records, human and AI classifiers showed good agreement in identifying studies not substantively using AI, but lower agreement in classifying human-AI interaction, particularly where health professional interaction was ambiguous or insufficiently described. Overall, the results suggest that hybrid human-AI screening of clinical trial records is potentially viable, but clearer trial reporting and more precise interaction definitions will benefit the process.

Sandra Woolley, Tim Collins, Khalid Khattak +3

a Keele University, UK · b Manchester Metropolitan University, UK

Healthcare Human-AI Agreement AI-Assisted Scientific Research Human-AI Interaction

May 27, 2026cs.CL

Same Question, Different Source, Different Answer: Auditing Source-Dependence in Medical Multi-Source RAG

A retrieval-augmented generation (RAG) system deployed over a multi-author institutional corpus can give a different answer to the same question depending on which source it retrieves -- a failure mode the dominant single-gold-answer paradigm cannot diagnose. We argue that source-dependence is a missing axis of NLP evaluation, and that auditing it means shifting the unit of evaluation from answer correctness to the inter-source relationship. We make this concrete in transplant patient education, where institutional sources demonstrably disagree, releasing three artefacts: TransplantQA, a benchmark of real patient questions, each answered by grounding generation in multiple institutional handbooks as candidate sources; HERO-QA, a hierarchical retrieval strategy that grounds and audits each answer; and a structured-output judge that scores inter-source relationships on a validated 5-label taxonomy. At scale, better retrieval reveals far more disagreement than prior estimates suggested -- understating its prevalence, not its intensity. The framework is domain-agnostic and transfers to legal and educational RAG: measuring source-dependence is a responsibility for deployed multi-source NLP generally.

Yubo Li, Rema Padman, Ramayya Krishnan

Carnegie Mellon University

Retrieval-Augmented Generation Healthcare Clinical QA RAG Evaluation

May 27, 2026cs.CL

Hallucination Detection-Guided Preference Optimization for Clinical Summarization

Large language models (LLMs) have shown promise on summarization tasks, but they often produce hallucinations, which are unsupported or incorrect statements that limit their reliability in specialized healthcare applications. We introduce Hallucination Detection Guided Self-Refinement (HDSR), an inference-time method that leverages hallucination detectors to guide iterative summary revisions toward factual corrections. Building on this, we propose HDSR for Preference Learning (HDSR-PL), which converts detector-guided refinement trajectories into preference pairs for model finetuning. Extensive experiments show that our methods substantially reduce hallucinations for Llama and Gemma models in summarizing real-world clinical notes from MIMIC-IV-Note v2.2. For example, HDSR reduces 24% and HDSR-PL reduces 48% hallucinations in Llama-3.1-8B-Instruct. Importantly, both methods preserve summary fluency, coherence, and relevance according to human expert and LLM-Jury evaluations. Together, these results demonstrate that detection-informed refinement and preference learning offer an automated solution for improving factual faithfulness in clinical summarization.

Shamanth Kuthpadi Seethakantha, Dung Ngoc Thai, Vara Prasad Gudi +6

1Manning College of Information and Computer Sciences · 2Ensemble HP · 3Columbia University +1

LLM Self-Refinement LLM Hallucination Mitigation Healthcare Hallucination in Language Models Text Summarization Preference Optimization

May 27, 2026cs.CL

ClinicalEncoder26AM: A Multlilingual Diagnosable ColBERT Model; Evidences from the MultiClinNER Shared Task

ClinicalEncoder26AM is a multilingual Diagnosable ColBERT for clinical and biomedical texts, which aligns at multiple levels its token-level semantic with ClinicalMap25, a clinical latent space inspired by BioLORD-2023 and enriched with synthetic and annotated supervision. The post-training recipe builds upon BGE-M3, and combines synthetic clinical notes, patient--doctor conversations, and annotated resources such as MedMentions, while considering both named-entity-level and sentence-level representations in a multi-adapter distillation, along with a ColBERT-style retrieval objective. In this system demonstration paper, we evaluate the model in the MultiClinNER shared task by finetuning it as a BIO tagger for patient symptoms, disorders, and procedure spans, using a lightweight two-layer CNN head to improve local boundary detection. The resulting system remains simple, processes most documents in a single 8192-token window, and achieves state-of-the-art multilingual entity recall, while achieving Top 5 overall across all entity types and languages in Character-weighted F1 scores. Training curves further show that ClinicalEncoder26AM is markedly more data-efficient than the base M3 model, supporting the usefulness of its clinical post-training for downstream information extraction. The model can be downloaded on https://huggingface.co/Parallia/ClinicalEncoder26AM-Diagnosable-Colbert-L2-for-multilingual-medical-texts

François Remy

Parallia AI

Named Entity Recognition Healthcare Clinical Information Extraction Multi-Vector Retrieval Text Embedding Models Clinical NLP

May 27, 2026cs.CL

PrionNER: A Named Entity Recognition Dataset for Prion Disease Biomedical Literature

Prion diseases are rare, rapidly progressive, and fatal neurodegenerative disorders that remain difficult to diagnose, particularly in their early stages because of nonspecific clinical presentations. However, to our knowledge, there is no publicly available prion-disease-focused dataset designed to capture a broad range of clinically relevant entities from the biomedical literature. We introduce PrionNER, a manually annotated named entity recognition dataset for prion disease clinical information in PubMed abstracts. The current release comprises 317 abstracts, 2,943 sentences, and 6,955 text-bound entity annotations spanning 15 coarse-grained and 31 fine-grained clinically oriented entity types covering diseases, symptoms, diagnostics, findings, anatomy, treatments, and temporal and statistical evidence. Inter-annotator agreement reaches 81.78 exact-match F1, indicating strong annotation consistency. We benchmark supervised BERT baselines, W2NER, and zero-shot extractors on PrionNER. W2NER is the strongest supervised model, and Gemma-4-31B is the strongest zero-shot model, but the benchmark remains challenging, especially for structurally complex mentions and fine-grained clinically adjacent label distinctions. PrionNER provides a clinically grounded benchmark for prion-disease information extraction and supports research on rare-disease biomedical NLP under low-resource, fine-grained, and non-flat extraction conditions. The dataset, annotation guidelines, and evaluation scripts are available at https://github.com/daotuanan/PrionNER/.

An Dao, Nhan Ly, Thao Tran +2

The University of Tokyo, Tokyo, Japan · Medical Doctor, Independent Researcher · Center for Language AI Research, Tohoku University, Sendai, Japan +2

Named Entity Recognition Healthcare Clinical Information Extraction LLM Information Extraction

May 27, 2026cs.AI

SafeMed-R1: Clinician-Audited Safety and Ethics Alignment for Medical Large Language Models

Large language models(LLMs) increasingly match expert performance on licensing examinations, yet routine clinical use remains limited because governance requires auditable reasoning, safety and ethics alignment, and resilience to adversarial misuse. Here we present SafeMed-R1, trained with a traceable Clinical Trust Signals(CTS) pipeline that links each reasoning instance to clinician rubric scores and edit histories, and aligned through safety and ethics supervision and red team stress testing. SafeMed-R1 attains a macro-averaged accuracy of 79.6% across clinical benchmarks. Under adversarial safety testing, it shows the lowest aggregated risk and reduces unsafe outputs by about 3 to 5% relative to its baseline. In a paired expert study of 30 medication safety vignettes, SafeMed-R1 matches PGY1 and PGY2 residents on medical correctness and scores higher for medication safety, guideline consistency, and clinical usefulness. Collectively, these results suggest that clinician-audited supervision provenance, together with domain-tailored safety and ethics alignment, can strengthen governance-relevant evidence without relying on inference-time retrieval or citation grounding.

Chao Ding, Mouxiao Bian, Tianbin Li +12

Shanghai Artificial Intelligence Laboratory, Shanghai, China · Joint Laboratory of Biomedical Artificial Intelligence, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China · School of Computer Science and Technology, Tongji University, Shanghai, China +5

Healthcare LLM Auditing LLM Safety Alignment Adversarial Robustness of Language Models Clinical Language Model Evaluation Medical LLMs

May 27, 2026cs.AI

Do Clinical Models Change Treatment Decisions?

Clinical foundation models are evaluated with factual or exam-style medical QA, but treatment decisions must change when patient context changes. We introduce ClinPivot, an auditable treatment-decision benchmark built from biomedical relations and pivoted patient contexts. ClinPivot asks whether models change treatment choices when new clinical constraints shift the action space. We find that strong medical QA performance does not reliably predict decision-making performance: frontier models and task-adapted Qwen variants often fail to change decisions correctly, and model rankings shift across evaluation regimes. Decision-structured supervision improves pivot-sensitive decision-making and medical QA under matched knowledge budgets, while lightweight replay reduces losses in general assistant ability.

Dongkyu Cho, Miao Zhang, Rumi Chunara

New York University

Healthcare Clinical Decision-Making Clinical Language Model Evaluation

May 27, 2026cs.AI

BuddyBench: A Privacy-Constrained Multi-Task Benchmark for Pediatric Social-Communication Personalization

BuddyBench introduces a privacy-constrained multi-task benchmark for pediatric social-communication personalization. Unlike existing neurodevelopmental repositories that primarily emphasize imaging, genetics, or cross-sectional clinical phenotyping, BuddyBench links drill-level learning trajectories, standardized clinical assessments, BuddyPlan self-report, and randomized-treatment endpoints within a unified benchmark schema. BuddyBench combines two cohorts: ND-03 is an observational cohort with dense drill coverage for Tasks1-2 (n = 189), and ND-02 is a randomized controlled trial cohort for Tasks3-4 (n = 86 ITT). Together, they support knowledge tracing, next-drill recommendation, clinical prediction, and causal inference, linking behavioral personalization to clinical evaluation. We additionally introduce BuddyBench-Sim, a synthetic companion dataset for reproducible evaluation. Baselines show signal across tasks while keeping pediatric clinical records protected.

Jeyeon Eo, Joo Young Kim, Ran Ju +2

1Independent Researcher, Seoul, Republic of Korea · 2Neudive Inc., Daegu, Republic of Korea · 3Korea University, Sejong, Republic of Korea

Sequential Recommendation Healthcare Benchmark Design Knowledge Tracing

May 27, 2026cs.AI

MIRA: A Bilingual Benchmark for Medical Information Response Audit

Existing safety evaluations for large language models overlook whether responses preserve comparable medical information across different user phrasings of the same question. To address this, we introduce the Medical Information Response Audit (MIRA), a bilingual, controlled benchmark that assesses whether LLMs provide comparable medical information across user-side language, register, and health literacy signals. MIRA contains 4,320 prompts built from 60 medically reviewed, low-risk health questions. Across five mainstream LLMs, models answered all medical questions, but responses to low health-literacy signals consistently omitted more key information, provided fewer concrete next steps, and offered less support for independent judgment. We term this pattern Differential Information Dilution (DID). A comparison with 300 real-world health queries provides preliminary evidence of rank-order validity. A knowledge-guided mitigation prompt reduces information dilution for most models, with the largest reductions in underinformative simplification observed for Claude (~8%) and Qwen (~6%). Code and data are available at https://github.com/Rainxu09/MIRA.

Mengyu Xu, Qiaoxin Yang, Qianqian Wang +3

The University of Chicago · The Chinese University of Hong Kong, Shenzhen · Jinzhou Medical University +3

Multilingual Language Model Evaluation Healthcare LLM Auditing Language Model Bias Evaluation Clinical Language Model Evaluation

May 27, 2026cs.AI

C-MIG: Multi-view Information Gain-based Retrieval-Augmented Generation for Clinical Diagnosis Reasoning

Retrieval-augmented generation combined with reinforcement learning has shown promise for grounding large language models in trustworthy medical evidence. However, existing methods rely on exact-match binary rewards, which in clinical diagnosis cause two issues: (i) semantically relevant but non-verbatim steps receive zero signal, discarding valuable learning signals; and (ii) uni-dimensional rewards cannot effectively supervise heterogeneous reasoning capabilities. To address these issues, we propose C-MIG, a Multi-view Information Gain-based retrieval-augmented generation framework for Clinical diagnosis. C-MIG estimates information gain under a frozen reference model from two complementary views, retrieved-document and document-refinement, to jointly guide what to retrieve and how to refine, alleviating the issues of valuable reward signal loss and credit assignment. We further design a multi-subquery retrieval augmentation strategy that improves knowledge recall coverage in clinical diagnostic scenarios. Comprehensive experiments on four medical benchmarks demonstrate that C-MIG achieves the best performance among all RAG-RL methods on both in-domain and out-of-domain sets, and outperforms state-of-the-art general-purpose LLMs for clinical diagnosis.

Yuwei Miao, Gen Li, Yunsheng Zeng +8

1Baidu Inc.

Retrieval-Augmented Generation Healthcare RL for Language Model Reasoning Clinical Reasoning Information Retrieval Medical LLMs

May 26, 2026cs.LG

Normal Guidance is what Attention Needs

We consider training classifiers for 3D medical images using only one binary label for the entire volume rather than a label for each 2D slice. In such weakly supervised settings, can we learn accurate classifiers for slice-level predictions? Attention-based multiple instance learning (MIL) can produce an attention score for every slice. Yet recent work demonstrates that a simple center-focused baseline that ignores image content can outperform attention-based and transformer-based MIL at slice-level classification of 3D brain scans. We show this baseline also outperforms existing MIL at slice-level classification of thoracic and abdominal CT scans. Motivated by this baseline, we propose Normal Guidance, a regularization technique that encourages the learned attention distribution to follow a bell-shaped curve. Across three medical imaging datasets totaling over 4 million 2D slices, we show our Normal Guidance enables attention-based and transformer-based MIL methods to deliver significantly better slice-level localization than the state-of-the-art while remaining competitive at whole-scan classification.

Ethan Harvey, Dennis Johan Loevlie, Michael C. Hughes

Department of Computer Science Tufts University

Healthcare 3D Medical Imaging Medical Image Classification Weakly Supervised Learning Multiple Instance Learning

May 26, 2026cs.CL

Not All Tokens Matter Equally: Dynamic In-context Vector Distillation with Decisive-Token Supervision for Long-form Medical Report Generation

Distilling demonstration effects into hidden-space interventions offers a lightweight alternative to full finetuning. However, existing multimodal variants are mostly evaluated on short-form tasks, where outputs end after a few tokens. Extending these methods to long-form generation exposes a fundamental yet underexamined limitation: token-level distillation implicitly treats all output tokens as equally informative, but long-form outputs are dominated by high-frequency template and grammatical tokens, while the tokens that actually determine output quality are sparsely distributed. In medical report generation (MRG), two such decisive tokens stand out: pathology-related tokens that determine diagnostic content, and the end-of-sequence (EOS) event that determines termination. Both receive insufficient supervision under uniform cross-entropy, and autoregressive decoding further compounds the problem by drifting away from teacher-forced trajectories. We propose DIVE, a frozen-backbone distillation framework that addresses long-form report generation through two complementary mechanisms matched to these failures. Decisive-token supervision restores supervision balance by upweighting the cross-entropy contribution of pathology-related tokens and the EOS event, ensuring that content fidelity and termination are learned during training rather than imposed at decoding time. State-conditioned dynamic steering replaces fixed open-loop residuals with hidden-state-dependent adapters, allowing the injected signal to adapt as decoding drifts. Experiments on MIMIC-CXR and CheXpert Plus with two medical VLM backbones show that DIVE consistently ranks among the strongest methods across lexical and clinical-proxy metrics. Our method achieves the best BLEU-4, ROUGE-L, and RadGraph F1 in all dataset--backbone settings, while remaining competitive on coarse label-level CheXbert F1.

Ning Wu, Rui Liu, Xinkun Lin +5

UNSW Sydney, Sydney, Australia · University of Technology Sydney, Sydney, Australia · School of Computer Science and Engineering, Sun Yat-sen University, China +2

Medical Report Generation Long-Form Document Generation Healthcare Medical VLMs Language Model Distillation

May 26, 2026cs.CY

When Medical Safety Alignment Fails: A Benchmark for Evaluating LLMs on High-Risk Medical Queries

Large language models (LLMs) are increasingly used for medical and health-related questions, yet their safety in high-risk medical scenarios remains poorly understood. We introduce \textsc{MedHarm}\footnote{Code and data will be released upon acceptance. Due to the sensitive nature of high-risk medical queries, data access will be available to qualified researchers upon request.}, a high-risk medical safety benchmark with 1,100 medically grounded queries across 10 safety-critical categories, including toxicology, pharmacology, covert poisoning, anesthesia, and fetal harm. Unlike broad medical QA benchmarks, \textsc{MedHarm} targets realistic clinical, educational, and technical prompts that require refusal, caution, or safe redirection rather than direct helpfulness. We evaluate 15 LLMs spanning general-purpose, medical-purpose, closed-source, and downstream SFT models, together with 4 representative guardrail models. Results reveal a substantial gap between apparent alignment and medical safety: aligned models can still produce unsafe or actionable responses, medical fine-tuning can amplify harmful specificity, and external guardrails reduce some failures while introducing brittle blocking and weak safe helpfulness. These findings show that medical safety cannot be inferred from general alignment or medical capability alone, highlighting the need for domain-specific stress testing before deploying LLMs in safety-critical medical applications.

Yige Li, Jun Sun, Wei Zhao +5

Singapore Management University · Deakin University · The University of Melbourne +2

LLM Safety Benchmarks Healthcare LLM Guardrails LLM Safety Alignment LLM Safety Evaluation Medical LLMs