Triage

Online patient inquiries are often informal, incomplete, and written before professional assessment, yet they must still be routed to an appropriate level of clinical follow-up. We study this as a four-class actionable triage task -- self-care, schedule-visit, urgent-clinician-review, or emergency-referral, and ask whether prompted large language models (LLMs) can support such routing under low-resource labeling conditions. Using the public HealthCareMagic-100K corpus, we construct a 300-example human calibrated gold evaluation set, a 700-example auto-labeled silver training set, and a 40-example few-shot pool. We compare Term Frequency-Inverse Document Frequency (TF-IDF) and Bidirectional Encoder Representations from Transformers for Biomedical Text Mining (BioBERT) baselines train on silver labels against six prompted LLMs under 0-shot, 4-shot, and 12-shot conditions respectively. Accordingly, we evaluate with macro-$F_1$ alongside safety-aware metrics, including emergency-recall, under-triage rate, and severe under-triage rate. The strongest LLM (Claude Haiku 4.5, 12-shot) reaches macro-$F_1$ 0.475, exceeding the best supervised baseline (BioBERT, 0.378) on point estimate, with overlapping confidence intervals. Few-shot prompting and two-model agreement help in label-dependent ways: self-care agreement is reliable, urgent-clinician-review is not. We conclude that LLMs can support triage prioritization and selective human review, but not autonomous deployment.

LLM-based root cause analysis (RCA) agents have recently emerged as a promising paradigm for incident diagnosis in microservice AIOps. However, their reliability remains fragile: an error in early evidence collection, hypothesis formulation, or causal analysis can propagate through the reasoning trace and eventually corrupt the final diagnosis. In this paper, we present \textbf{STAR}, a \emph{Stage-attributed Triage and Repair} framework for repairing erroneous RCA traces. STAR explicitly decomposes an RCA workflow into four structured stages, namely \emph{Evidence Package} (EP), \emph{Hypothesis Set} (HS), \emph{Analysis Structure} (AS), and \emph{Decision Report} (DR), and treats agent failure as a stage-localizable reasoning bug rather than a monolithic end-to-end error. Built on top of LangGraph, STAR performs stage-wise auditing, budget-aware \emph{Fast/Slow Routing}, \emph{decisive stage localization via counterfactual candidate evaluation}, and stage-specific patch-and-replay repair. We evaluate STAR on a public large-scale benchmark and a real-world production dataset, using two RCA agent workflows and three foundation models. Experimental results show that STAR consistently improves both root cause localization and fault type classification over strong baselines. Moreover, STAR identifies the decisive faulty stage with high accuracy, repairs most initially incorrect traces within one or two replay rounds, and benefits substantially from both Fast/Slow Routing and counterfactual stage evaluation. These results suggest that explicitly modeling \emph{where} an RCA agent fails is an effective path toward reliable, debuggable, and self-repairing agentic RCA systems.

Harmonized System (HS) tariff classification is a high-stakes, expert-level task in which a free-form product description must be mapped to a specific six- or eight-digit code under the General Interpretive Rules (GIR), section notes, chapter notes, and Explanatory Notes. The difficulty lies not in knowledge volume but in multi-dimensional rule reasoning: a correct classification must satisfy competing priority rules along several axes simultaneously, including material, form, function, essential character, the part-versus-whole boundary, and specific listing versus residual headings. End-to-end prompting of large language models fails characteristically by resolving one axis while ignoring the priority constraints on the others. We present a deterministic agentic workflow in contrast to self-planning agents: the control flow is fixed, language model calls are confined to narrow stages, and reflection and verification are retained as local mechanisms. This design yields interpretability by construction--each decision is decomposed into stage-wise structured outputs with verbatim citation of the chapter or section notes that bear on it. The architecture combines offline knowledge-engineering of the Chinese HS tariff with an online six-stage pipeline. Evaluated on HSCodeComp at the six-digit level, the workflow reaches 75.0% top-1 and 91.5% top-3 at four digits, and 64.2% top-1 and 78.3% top-3 at six digits with Qwen3.6-plus; an open-weight Qwen3.6-27B-FP8 backbone in non-thinking mode achieves 84.2% four-digit and 77.4% six-digit top-1 agreement with the frontier model. A two-stage manual audit of 226 six-digit disagreements suggests that a non-trivial fraction of HSCodeComp ground-truth labels may deviate from HS general rules; full adjudication records are released in the appendix as preliminary findings for community review.

Inferring spatially resolved gene expression from histology images offers a cost-effective complement to spatial transcriptomics (ST). However, existing methods reduce this task to a simple morphology-to-expression mapping, where visual similarity does not guarantee molecular consistency. Meanwhile, single-cell data has amassed rich resources far surpassing the scale of ST data, yet it remains underexplored in vision-omics modeling. Furthermore, current approaches commit to a monolithic paradigm with bottlenecks, unable to balance expressive flexibility with biological fidelity. To bridge these gaps, we propose DUET, a novel dual-paradigm framework that synergizes parametric prediction and memory-based retrieval under cellular inductive priors. DUET implements a parallel regression-retrieval paradigm, adaptively reconciling the outputs of its complementary pathways. To mitigate aleatoric vision ambiguity, we incorporate large-scale single-cell references to impose molecular states as biological constraints for faithful learning. Building upon structural refinement, we further design a lightweight adapter to dynamically assign branch preference across spatial contexts to achieve optimal performance. Extensive experiments on three public datasets across varied gene scales demonstrate that DUET achieves SOTA performance, with consistent gains contributed by each proposed component. Code is available at https://github.com/Junchao-Zhu/DUET

Deploying language models as autonomous agents requires more than per-task accuracy: when an agent faces a queue of problems under a finite token budget, it must decide which to attempt, in what order, and how much compute to commit to each, all before any execution feedback is available. This is the prospective form of metacognitive control studied for decades in human cognition, yet whether language models possess it remains untested. We introduce TRIAGE, an evaluation framework in which a model receives a task pool and a token budget calibrated to its own baseline cost, and commits to a single ordered plan that jointly encodes selection, sequencing, and per-problem allocation. Plans are scored against an oracle with full knowledge of the model's solvability and cost on each problem, yielding a triage efficiency ratio on a common scale. We evaluate frontier and open-source models, with and without reasoning enabled, across competition mathematics, graduate-level science, code generation, and expert multidisciplinary knowledge, and find that current language models exhibit substantial gaps in prospective metacognitive control, revealing a previously unmeasured capability dimension with direct implications for resource-efficient agent deployment.

We introduce AcuityBench, a benchmark for evaluating whether language models identify the appropriate urgency of care from user medical presentations. Existing health benchmarks emphasize medical question answering, broad health interactions, or narrow workflow-specific triage tasks, but they do not offer a unified evaluation of acuity identification across these settings. AcuityBench addresses this gap by harmonizing five public datasets spanning user conversations, online forum posts, clinical vignettes, and patient portal messages under a shared four-level acuity framework ranging from home monitoring to immediate emergency care. The benchmark contains 914 cases, including 697 consensus cases for standard accuracy evaluation and 217 physician-confirmed ambiguous cases for uncertainty-aware evaluation. It supports two complementary task formats: explicit four-way classification in a QA setting, and free-form conversational responses evaluated with a rubric-based judge anchored to the same framework. Across 12 frontier proprietary and open-weight models, we find substantial variation in clear-case acuity accuracy and error direction. Comparing task formats reveals a systematic tradeoff: conversational responses reduce over-triage but increase under-triage relative to QA, especially in higher-acuity cases. In ambiguous cases, no model closely matches the distribution of physician judgments, and model predictions are more concentrated than expert clinical uncertainty. We also compare expert and model adjudication on a subset of maximally ambiguous cases, using those cases to examine the role of clinical uncertainty in label disagreement. Together, these results position acuity identification as a distinct safety-critical capability and show that AcuityBench enables systematic comparison and stress-testing of how well models guide users to the right level of care in real-world health use.

Anomaly detection methods can be very useful in identifying unusual or interesting patterns in data. A recently proposed conditional anomaly detection framework extends anomaly detection to the problem of identifying anomalous patterns on a subset of attributes in the data. The anomaly always depends (is conditioned) on the value of remaining attributes. The work presented in this paper focuses on instance-based methods for detecting conditional anomalies. The methods rely on the distance metric to identify examples in the dataset that are most critical for detecting the anomaly. We investigate various metrics and metric learning methods to optimize the performance of the instance-based anomaly detection methods. We show the benefits of the instance-based methods on two real-world detection problems: detection of unusual admission decisions for patients with the community-acquired pneumonia and detection of unusual orders of an HPF4 test that is used to confirm Heparin induced thrombocytopenia - a life-threatening condition caused by the Heparin therapy.

Autonomous drone fleets have immense potential in medical supply delivery during disaster incident response. However, coordinating multiple drones in such settings introduces compounding challenges: dynamic environmental hazards such as wind, obstacles, and intermittent network connectivity, constrained energy budgets, and the need to serve patient locations fairly under deadlines and triage-based priority while optimizing schedule utilization. In this paper, we present CEDA, a novel CTDE Deep Q-Network algorithm for cooperative multi-drone medical delivery, designed to jointly optimize triage-priority-aware routing, multi-agent coordination, and energy-efficient navigation under dynamic uncertainty. CEDA introduces a Priority-Preserving Fair Scheduling strategy, in which a structured reward function encodes both triage weights and complementary fairness mechanisms ensuring no patient class is starved of service. We evaluate CEDA in a simulated grid environment featuring dynamic hazard zones, stochastic action failures, and dynamically spawning patients across three triage priority levels, as well as in a PX4 SITL validation using two X500 quadrotors controlled via MAVSDK in offboard position mode. Simulation results demonstrate that CEDA achieves a delivery completion rate above 85%, reduces obstacle collisions by over 90% across training, and delivers an average of 6 patients per episode with a triage efficiency of 0.82. CEDA preserves clinical priority ordering, Critical patients are served first, while achieving near-zero mortality across lower-triage classes, confirming that priority-weighted routing does not condemn Stable or Urgent patients to neglect. PX4 SITL validation further demonstrates that the learned policy remains executable and triage-coherent under practical communication constraints and realistic multi-drone coordination in disaster response settings.

Learning-to-defer (L2D) can make glaucoma screening safer by routing difficult/uncertain cases to humans, yet standard formulations overlook expert availability, heterogeneous readers behavior, workload imbalance, asymmetric diagnostic harm, case difficulty from morphology and deployment shift. We introduce MPD$^2$-Router, a mask-aware multi-expert deferral framework that recasts ophthalmic triage as constrained human--AI routing: whether to defer and to which available expert. It couples a dual-head deferral/allocation policy with mask-aware Gumbel--sigmoid gating that strictly enforces per-sample availability, and fuses uncertainty, morphology, image-quality, and OOD signals. Training uses an asymmetric cost-sensitive objective with an augmented-Lagrangian deferral budget, a group-specific distribution prior, and a rank-majorization JS regularizer that jointly prevent expert collapse without forcing uniform allocation. Across three cross-national glaucoma cohorts (REFUGE, CHAKSU, ORIGA) with a frozen REFUGE-trained backbone, MPD$^2$-Router substantially lowers clinical cost and improves MCC over AI-only at a moderate deferral rate. It is Pareto-optimal in F1--MCC--cost, robust under cross-domain shift, and yields balanced expert utilization.

Large language model (LLM) agents are increasingly applied to network troubleshooting, but root-cause localization on public benchmarks remains well below practical deployment thresholds. We argue this is because existing agents do not encode the disciplined, layer-by-layer methodology that human network engineers use, and instead rely on free-form deliberation that conflates evidence acquisition with hypothesis commitment. We present SADE (Symptom-Aware Diagnostic Escalation), an agent that encodes the classical Cisco troubleshooting methodology as an explicit policy. SADE pairs a phase-gated diagnostic workflow, which separates evidence acquisition from hypothesis commitment, with a routed library of fault-family skills and high-yield diagnostic helpers. On a held-out 523 incident set of the public NIKA benchmark covering eleven unseen scenarios, SADE improves root-cause F1 by 37 percentage points over a ReAct + GPT-5 baseline; a model-controlled comparison against the same Claude Sonnet backend without the SADE policy attributes 22 of those points to the diagnostic policy alone, showing that the gain is not a side-effect of the model upgrade.

Emergency department triage assigns patients an acuity score that determines treatment priority, and clinical evidence documents persistent gender disparities in human acuity assessment. As hospitals pilot large language models (LLMs) as triage decision support, a critical question is whether these models reproduce or mitigate known biases. We present EQUITRIAGE, a fairness audit of LLM-based ESI assignment evaluating five models (Gemini-3-Flash, Nemotron-3-Super, DeepSeek-V3.1, Mistral-Small-3.2, GPT-4.1-Nano) across 374,275 evaluations on 18,714 MIMIC-IV-ED vignettes under four prompt strategies. Of 9,368 originals, 9,346 are paired with a gender-swapped counterfactual. All five models produced flip rates above a pre-registered 5% threshold (9.9% to 43.8%). Two showed directional female undertriage (DeepSeek F/M 2.15:1, Gemini 1.34:1); two were near-parity; one had high sensitivity with weak male-direction asymmetry. DeepSeek's directional bias coexisted with a low outcome-linked calibration gap (0.013 against MIMIC-IV admission), a Chouldechova-style dissociation between within-group calibration and between-pair counterfactual invariance. Demographic blinding reduced Gemini's flip rate to 0.5%; an age-preserving blind variant left DeepSeek with residual F/M 1.25, implicating age as a residual channel. Chain-of-thought prompting degraded accuracy for all five models. A two-model ablation reveals opposite underlying mechanisms for the same directional phenotype: in Gemini the signal is emergent in the combined name+gender swap, while in DeepSeek the gender token alone carries it. EQUITRIAGE shows that group parity, counterfactual invariance, and gender calibration are distinct fairness properties, that intervention effectiveness is model-dependent, and that per-model counterfactual auditing should precede clinical deployment.

Pneumonia remains a leading global cause of morbidity and mortality, particularly in low-resource settings where access to imaging, laboratory testing, and specialist care is limited. Clinical assessment relies on heterogeneous evidence, including symptoms, respiratory patterns, spoken descriptions, and chest imaging, making frontline screening inherently multimodal. However, many existing computational approaches remain unimodal and focus primarily on radiographs. In this work, we present MultiSense-Pneumo, a multimodal research prototype for pneumonia-oriented screening and triage support that integrates structured symptom descriptors, cough audio, spoken language, and chest radiographs. The system combines deterministic symptom triage, LightGBM-based acoustic classification, domain-adversarial radiograph analysis using ResNet-18, transformer-based speech recognition, and an interpretable late-fusion operator. Each modality is transformed into a normalized concern signal and aggregated into a unified screening estimate. The fusion weights are hand-specified and are treated as heuristic, interpretable parameters rather than learned or clinically optimized values. MultiSense-Pneumo is implemented with offline execution in mind on standard laptop-class hardware, but it is not presented as a deployment-validated or clinically validated diagnostic system. Experimental results demonstrate strong component-level performance of the radiograph pathway under synthetic domain shifts, while also highlighting important limitations, especially reduced abnormal-class recall for cough acoustics and the absence of paired end-to-end multimodal patient evaluation. MultiSense-Pneumo is therefore intended as a framework and component-level prototype for screening and triage research.

Security Operations Centers (SOCs) face mounting operational challenges. These challenges come from increasing threat volumes, heterogeneous SIEM platforms, and time-consuming manual triage workflows. We present an end-to-end threat management framework that integrates ensemble-based detection, syntax-constrained query generation, and retrieval-augmented resolution support to automate critical security workflows. Our detection module evaluates both traditional machine learning classifiers and large language models (LLMs), then combines the three best-performing LLMs to create an ensemble model, achieving 82.8% accuracy while maintaining 0.120 false positive rate on SIEM logs. We introduce the SQM (Syntax Query Metadata) architecture for automated evidence collection. It uses platform-specific syntax constraints, metadata-based retrieval, and documentation-grounded prompting to generate executable queries for IBM QRadar and Google SecOps. SQM achieves a BLEU score of 0.384 and a ROUGE-L score of 0.731. These results are more than twice as good as the baseline LLM performance. For incident resolution and recommendation generation, we demonstrate that integrating SQM-derived evidence improves resolution code prediction accuracy from 78.3% to 90.0%, with an overall recommendation quality score of 8.70. In production SOC environments, our framework reduces average incident triage time from hours to under 10 minutes. This work demonstrates that domain-constrained LLM architectures with retrieval augmentation can meet the strict reliability and efficiency requirements of operational security environments at scale.

Accurate and consistent Emergency Severity Index (ESI) assignment remains a persistent challenge in emergency departments, where highly variable free-text triage documentation contributes to mistriage and workflow inefficiencies. This study evaluates whether open-source small language models (SLMs) can serve as reliable, privacy-preserving decision-support tools for clinical triage. We systematically compared multiple SLMs across diverse prompting pipelines and found that clinical vignettes, concise summaries of triage narratives, yielded the most accurate predictions. The SLM, Qwen2.5-7B, demonstrated the strongest balance of accuracy, stability, and computational efficiency. Through large-scale domain adaptation using expert-curated and silver-standard pediatric triage data, fine-tuned Qwen2.5-7B models substantially reduced discordance and clinically significant errors, outperforming all baseline SLMs and advanced proprietary large language models (LLMs, e.g., GPT-4o). These findings highlight the feasibility of institution-specific SLMs for reliable, privacy-preserving ESI decision support and underscore the importance of targeted fine-tuning over more complex inference strategies.

AI chatbots are increasingly used for health advice, but their performance in psychiatric triage remains undercharacterized. Psychiatric triage is particularly challenging because urgency must often be inferred from thoughts, behavior, and context rather than from objective findings. We evaluated the performance of 15 frontier AI chatbots on psychiatric triage from realistic single-message disclosures using 112 clinical vignettes, each paired with 1 of 4 original benchmark triage labels: A, routine; B, assessment within 1 week; C, assessment within 24 to 48 hours; and D, emergency care now. Vignettes covered 9 psychiatric presentation clusters and 9 focal risk dimensions, organized into 28 presentation-by-risk groups. Each group contributed 4 distinct vignettes, with 1 vignette at each triage level. Each vignette was rendered as a realistic human-authored conversational query, and the AI chatbots were tasked with assigning a triage label from that disclosure. Emergency under-triage occurred in 23 of 410 level D trials (5.6%), and all under-triaged emergencies were reassigned to level C urgency. Across target models, average accuracy ranged from 42.0% to 71.8%. Accuracy was highest for level D vignettes (94.3%) and lowest for level B vignettes (19.7%). Mean signed ordinal error was positive (+0.47 triage levels), indicating net over-triage. Dispersion was highest around the middle triage levels. All results were confirmed relative to clinician consensus labels from 50 medical doctors. When presented with user messages containing sufficient clinical information, frontier AI chatbots thus recognized psychiatric emergencies as requiring urgent medical assessment with near-zero error rates, yet showed marked over-triage for low and intermediate risk presentations.

Modern phishing campaigns increasingly evade snapshot-based URL classifiers using interaction gates (e.g., checkbox/slider challenges), delayed content rendering, and logo-less credential harvesters. This shifts URL triage from static classification toward an interactive forensics task: an analyst must actively navigate the page while isolating themselves from potential runtime exploits. We present TraceScope, a decoupled triage pipeline that operationalizes this workflow at scale. To prevent the observer effect and ensure safety, a sandboxed operator agent drives a real GUI browser guided by visual motivation to elicit page behavior, freezing the session into an immutable evidence bundle. Separately, an adjudicator agent circumvents LLM context limitations by querying evidence on demand to verify a MITRE ATT&CK checklist, and generates an audit-ready report with extracted indicators of compromise (IOCs) and a final verdict. Evaluated on 708 reachable URLs from existing dataset (241 verified phishing from PhishTank and 467 benign from Tranco-derived crawling), TraceScope achieves 0.94 precision and 0.78 recall, substantially improving recall over three prior visual/reference-based classifiers while producing reproducible, analyst-grade evidence suitable for review. More importantly, we manually curated a dataset of real-world phishing emails to evaluate our system in a practical setting. Our evaluation reveals that TraceScope demonstrates superior performance in a real-world scenario as well, successfully detecting sophisticated phishing attempts that current state-of-the-art defenses fail to identify.

Autonomous robots deployed in mass casualty incidents (MCI) face the challenge of making critical decisions based on incomplete and noisy perceptual data. We present an autonomous robotic system for casualty assessment that fuses outputs from multiple vision-based algorithms, estimating signs of severe hemorrhage, visible trauma, or physical alertness, into a coherent triage assessment. At the core of our system is a Bayesian network, constructed from expert-defined rules, which enables probabilistic reasoning about a casualty's condition even with missing or conflicting sensory inputs. The system, evaluated during the DARPA Triage Challenge (DTC) in realistic MCI scenarios involving 11 and 9 casualties, demonstrated a nearly three-fold improvement in physiological assessment accuracy (from 15% to 42% and 19% to 46%) compared to a vision-only baseline. More importantly, overall triage accuracy increased from 14% to 53%, while the diagnostic coverage of the system expanded from 31% to 95% of cases. These results demonstrate that integrating expert-guided probabilistic reasoning with advanced vision-based sensing can significantly enhance the reliability and decision-making capabilities of autonomous systems in critical real-world applications.

LLMs are increasingly being considered for prediction tasks in high-stakes social service settings, but their algorithmic fairness properties in this context are poorly understood. In this short technical report, we audit the algorithmic fairness of LLM-based tabular classification on a real housing placement prediction task, augmented with street outreach casenotes from a nonprofit partner. We audit multi-class classification error disparities. We find that a fine-tuned model augmented with casenote summaries can improve accuracy while reducing algorithmic fairness disparities. We experiment with variable importance improvements to zero-shot tabular classification and find mixed results on resulting algorithmic fairness. Overall, given historical inequities in housing placement, it is crucial to audit LLM use. We find that leveraging LLMs to augment tabular classification with casenote summaries can safely leverage additional text information at low implementation burden. The outreach casenotes are fairly short and heavily redacted. Our assessment is that LLM zero-shot classification does not introduce additional textual biases beyond algorithmic biases in tabular classification. Combining fine-tuning and leveraging casenote summaries can improve accuracy and algorithmic fairness.

Current agent evaluations largely reward execution on fully specified tasks, while recent work studies clarification [11, 22, 2], capability awareness [9, 1], abstention [8, 14], and search termination [20, 5] mostly in isolation. This leaves open whether agents can diagnose why a task is blocked before acting. We introduce the Support-State Triage Audit (SSTA-32), a matched-item diagnostic framework in which minimal counterfactual edits flip the same base request across four support states: Complete (ANSWER), Clarifiable (CLARIFY), Support-Blocked (REQUEST SUPPORT), and Unsupported-Now (ABSTAIN). We evaluate a frontier model under four prompting conditions - Direct, Action-Only, Confidence-Only, and a typed Preflight Support Check (PSC) - using Dual-Persona Auto-Auditing (DPAA) with deterministic heuristic scoring. Default execution overcommits heavily on non-complete tasks (41.7% overcommitment rate). Scalar confidence mapping avoids overcommitment but collapses the three-way deferral space (58.3% typed deferral accuracy). Conversely, both Action-Only and PSC achieve 91.7% typed deferral accuracy by surfacing the categorical ontology in the prompt. Targeted ablations confirm that removing the support-sufficiency dimension selectively degrades REQUEST SUPPORT accuracy, while removing the evidence-sufficiency dimension triggers systematic overcommitment on unsupported items. Because DPAA operates within a single context window, these results represent upper-bound capability estimates; nonetheless, the structural findings indicate that frontier models possess strong latent triage capabilities that require explicit categorical decision paths to activate safely.