Daily Papers

Large language models (LLMs) face significant challenges in specialized biomedical tasks due to the inherent complexity of medical reasoning and the sensitive nature of clinical data. Existing LLMs often struggle with intricate medical terminology and the need for accurate clinical insights, leading to performance reduction when quantized for resource-constrained deployment. To address these issues, we propose Quantized Medical Tree of Thought (QM-ToT), a path-based reasoning framework. QM-ToT leverages a Tree of Thought (ToT) reasoning approach to decompose complex medical problems into manageable subtasks, coupled with evaluator assessment layers. This framework facilitates substantial performance improvements in INT4-quantized models on the challenging MedQAUSMLE dataset. Specifically, we demonstrate a remarkable accuracy increase from 34% to 50% for the LLaMA2-70b model and from 58.77% to 69.49% for LLaMA-3.1-8b. Besides, we also proposed an effect data distillation method based on ToT. Compared to the traditional distillation method, we achieved an improvement of 86. 27% while using only 3.9% of the data.This work, for the first time, showcases the potential of ToT to significantly enhance performance on complex biomedical tasks, establishing a crucial foundation for future advances in deploying high-performing quantized LLM in resource-limited medical settings.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

With the widespread use of large language models (LLMs) in NLP tasks, researchers have discovered the potential of Chain-of-thought (CoT) to assist LLMs in accomplishing complex reasoning tasks by generating intermediate steps. However, human thought processes are often non-linear, rather than simply sequential chains of thoughts. Therefore, we propose Graph-of-Thought (GoT) reasoning, which models human thought processes not only as a chain but also as a graph. By representing thought units as nodes and connections between them as edges, our approach captures the non-sequential nature of human thinking and allows for a more realistic modeling of thought processes. Similar to Multimodal-CoT, we modeled GoT reasoning as a two-stage framework, generating rationales first and then producing the final answer. Specifically, we employ an additional graph-of-thoughts encoder for GoT representation learning and fuse the GoT representation with the original input representation through a gated fusion mechanism. We implement a GoT reasoning model on the T5 pre-trained model and evaluate its performance on a text-only reasoning task (GSM8K) and a multimodal reasoning task (ScienceQA). Our model achieves significant improvement over the strong CoT baseline with 3.41% and 5.08% on the GSM8K test set with T5-base and T5-large architectures, respectively. Additionally, our model boosts accuracy from 84.91% to 91.54% using the T5-base model and from 91.68% to 92.77% using the T5-large model over the state-of-the-art Multimodal-CoT on the ScienceQA test set. Experiments have shown that GoT achieves comparable results to Multimodal-CoT(large) with over 700M parameters, despite having fewer than 250M backbone model parameters, demonstrating the effectiveness of GoT.

Large Language Models (LLMs) have demonstrated remarkable performance across multiple tasks through in-context learning. For complex reasoning tasks that require step-by-step thinking, Chain-of-Thought (CoT) prompting has given impressive results, especially when combined with self-consistency. Nonetheless, some tasks remain particularly difficult for LLMs to solve. Tree of Thoughts (ToT) and Graph of Thoughts (GoT) emerged as alternatives, dividing the complex problem into paths of subproblems. In this paper, we propose Tree of Problems (ToP), a simpler version of ToT, which we hypothesise can work better for complex tasks that can be divided into identical subtasks. Our empirical results show that our approach outperforms ToT and GoT, and in addition performs better than CoT on complex reasoning tasks. All code for this paper is publicly available here: https://github.com/ArmelRandy/tree-of-problems.

Medical tasks such as diagnosis and treatment planning require precise and complex reasoning, particularly in life-critical domains. Unlike mathematical reasoning, medical reasoning demands meticulous, verifiable thought processes to ensure reliability and accuracy. However, there is a notable lack of datasets that provide transparent, step-by-step reasoning to validate and enhance the medical reasoning ability of AI models. To bridge this gap, we introduce MedReason, a large-scale high-quality medical reasoning dataset designed to enable faithful and explainable medical problem-solving in large language models (LLMs). We utilize a structured medical knowledge graph (KG) to convert clinical QA pairs into logical chains of reasoning, or ``thinking paths'', which trace connections from question elements to answers via relevant KG entities. Each path is validated for consistency with clinical logic and evidence-based medicine. Our pipeline generates detailed reasoning for various medical questions from 7 medical datasets, resulting in a dataset of 32,682 question-answer pairs, each with detailed, step-by-step explanations. Experiments demonstrate that fine-tuning with our dataset consistently boosts medical problem-solving capabilities, achieving significant gains of up to 7.7% for DeepSeek-Ditill-8B. Our top-performing model, MedReason-8B, outperforms the Huatuo-o1-8B, a state-of-the-art medical reasoning model, by up to 4.2% on the clinical benchmark MedBullets. We also engage medical professionals from diverse specialties to assess our dataset's quality, ensuring MedReason offers accurate and coherent medical reasoning. Our data, models, and code will be publicly available.

Integration of Vision-Language Models (VLMs) in surgical intelligence is hindered by hallucinations, domain knowledge gaps, and limited understanding of task interdependencies within surgical scenes, undermining clinical reliability. While recent VLMs demonstrate strong general reasoning and thinking capabilities, they still lack the domain expertise and task-awareness required for precise surgical scene interpretation. Although Chain-of-Thought (CoT) can structure reasoning more effectively, current approaches rely on self-generated CoT steps, which often exacerbate inherent domain gaps and hallucinations. To overcome this, we present SurgRAW, a CoT-driven multi-agent framework that delivers transparent, interpretable insights for most tasks in robotic-assisted surgery. By employing specialized CoT prompts across five tasks: instrument recognition, action recognition, action prediction, patient data extraction, and outcome assessment, SurgRAW mitigates hallucinations through structured, domain-aware reasoning. Retrieval-Augmented Generation (RAG) is also integrated to external medical knowledge to bridge domain gaps and improve response reliability. Most importantly, a hierarchical agentic system ensures that CoT-embedded VLM agents collaborate effectively while understanding task interdependencies, with a panel discussion mechanism promotes logical consistency. To evaluate our method, we introduce SurgCoTBench, the first reasoning-based dataset with structured frame-level annotations. With comprehensive experiments, we demonstrate the effectiveness of proposed SurgRAW with 29.32% accuracy improvement over baseline VLMs on 12 robotic procedures, achieving the state-of-the-art performance and advancing explainable, trustworthy, and autonomous surgical assistance.

Knowledge of the medical decision process, which can be modeled as medical decision trees (MDTs), is critical to build clinical decision support systems. However, the current MDT construction methods rely heavily on time-consuming and laborious manual annotation. In this work, we propose a novel task, Text2MDT, to explore the automatic extraction of MDTs from medical texts such as medical guidelines and textbooks. We normalize the form of the MDT and create an annotated Text-to-MDT dataset in Chinese with the participation of medical experts. We investigate two different methods for the Text2MDT tasks: (a) an end-to-end framework which only relies on a GPT style large language models (LLM) instruction tuning to generate all the node information and tree structures. (b) The pipeline framework which decomposes the Text2MDT task to three subtasks. Experiments on our Text2MDT dataset demonstrate that: (a) the end-to-end method basd on LLMs (7B parameters or larger) show promising results, and successfully outperform the pipeline methods. (b) The chain-of-thought (COT) prompting method Wei2022ChainOT can improve the performance of the fine-tuned LLMs on the Text2MDT test set. (c) the lightweight pipelined method based on encoder-based pretrained models can perform comparably with LLMs with model complexity two magnititudes smaller. Our Text2MDT dataset is open-sourced at https://tianchi.aliyun.com/dataset/95414, and the source codes are open-sourced at https://github.com/michael-wzhu/text2dt.

Large Language Models (LLMs) have demonstrated impressive reasoning capabilities, yet their performance is highly dependent on the prompting strategy and model scale. While reinforcement learning and fine-tuning have been deployed to boost reasoning, these approaches incur substantial computational and data overhead. In this work, we introduce Adaptive Graph of Thoughts (AGoT), a dynamic, graph-based inference framework that enhances LLM reasoning solely at test time. Rather than relying on fixed-step methods like Chain of Thought (CoT) or Tree of Thoughts (ToT), AGoT recursively decomposes complex queries into structured subproblems, forming an dynamic directed acyclic graph (DAG) of interdependent reasoning steps. By selectively expanding only those subproblems that require further analysis, AGoT unifies the strengths of chain, tree, and graph paradigms into a cohesive framework that allocates computation where it is most needed. We validate our approach on diverse benchmarks spanning multi-hop retrieval, scientific reasoning, and mathematical problem-solving, achieving up to 46.2% improvement on scientific reasoning tasks (GPQA) - comparable to gains achieved through computationally intensive reinforcement learning approaches and outperforming state-of-the-art iterative approaches. These results suggest that dynamic decomposition and structured recursion offer a scalable, cost-effective alternative to post-training modifications, paving the way for more robust, general-purpose reasoning in LLMs.

We introduce Graph of Thoughts (GoT): a framework that advances prompting capabilities in large language models (LLMs) beyond those offered by paradigms such as Chain-of-Thought or Tree of Thoughts (ToT). The key idea and primary advantage of GoT is the ability to model the information generated by an LLM as an arbitrary graph, where units of information ("LLM thoughts") are vertices, and edges correspond to dependencies between these vertices. This approach enables combining arbitrary LLM thoughts into synergistic outcomes, distilling the essence of whole networks of thoughts, or enhancing thoughts using feedback loops. We illustrate that GoT offers advantages over state of the art on different tasks, for example increasing the quality of sorting by 62% over ToT, while simultaneously reducing costs by >31%. We ensure that GoT is extensible with new thought transformations and thus can be used to spearhead new prompting schemes. This work brings the LLM reasoning closer to human thinking or brain mechanisms such as recurrence, both of which form complex networks.

Chain-of-thought (CoT) decoding enables language models to improve reasoning performance at the cost of high generation latency in decoding. Recent proposals have explored variants of contemplation tokens, a term we introduce that refers to special tokens used during inference to allow for extra computation. Prior work has considered fixed-length sequences drawn from a discrete set of embeddings as contemplation tokens. Here we propose Compressed Chain-of-Thought (CCoT), a framework to generate contentful and continuous contemplation tokens of variable sequence length. The generated contemplation tokens are compressed representations of explicit reasoning chains, and our method can be applied to off-the-shelf decoder language models. Through experiments, we illustrate how CCoT enables additional reasoning over dense contentful representations to achieve corresponding improvements in accuracy. Moreover, the reasoning improvements can be adaptively modified on demand by controlling the number of contemplation tokens generated.

Current Large Language Models (LLMs) exhibit significant limitations, notably in structured, interpretable, and verifiable medical reasoning, alongside practical deployment challenges related to computational resources and data privacy. This report focused on the development of WiNGPT-3.0, the 32-billion parameter LLMs, engineered with the objective of enhancing its capacity for medical reasoning and exploring its potential for effective integration within healthcare IT infrastructures. The broader aim is to advance towards clinically applicable models. The approach involved a multi-stage training pipeline tailored for general, medical, and clinical reasoning. This pipeline incorporated supervised fine-tuning (SFT) and reinforcement learning (RL), leveraging curated Long Chain-of-Thought (CoT) datasets, auxiliary reward models, and an evidence-based diagnostic chain simulation. WiNGPT-3.0 demonstrated strong performance: specific model variants achieved scores of 66.6 on MedCalc and 87.1 on MedQA-USMLE. Furthermore, targeted training improved performance on a clinical reasoning task from a baseline score of 58.1 to 62.5. These findings suggest that reinforcement learning, even when applied with a limited dataset of only a few thousand examples, can enhance medical reasoning accuracy. Crucially, this demonstration of RL's efficacy with limited data and computation paves the way for more trustworthy and practically deployable LLMs within clinical workflows and health information infrastructures.

Large Reasoning Models(LRMs) such as OpenAI o1 and DeepSeek-R1 have shown remarkable reasoning capabilities by scaling test-time compute and generating long Chain-of-Thought(CoT). Distillation--post-training on LRMs-generated data--is a straightforward yet effective method to enhance the reasoning abilities of smaller models, but faces a critical bottleneck: we found that distilled long CoT data poses learning difficulty for small models and leads to the inheritance of biases (i.e. over-thinking) when using Supervised Fine-tuning(SFT) and Reinforcement Learning(RL) methods. To alleviate this bottleneck, we propose constructing tree-based CoT data from scratch via Monte Carlo Tree Search(MCTS). We then exploit a set of CoT-aware approaches, including Thoughts Length Balance, Fine-grained DPO, and Joint Post-training Objective, to enhance SFT and RL on the construted data.

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

Traditional Chinese medicine (TCM) plays a vital role in health protection and disease treatment, but its practical application requires extensive medical knowledge and clinical experience. Existing TCM Large Language Models (LLMs) exhibit critical limitations of uncomprehensive medical consultation and diagnoses, and inaccurate syndrome differentiation-based treatment. To address these issues, this study establishes JingFang (JF): a novel TCM Large Language Model that demonstrates the expert-level capability of medical diagnosis and syndrome differentiation-based treatment. We innovate a Multi-agent Dynamic Collaborative Chain-of-Thought Mechanism (MDCCTM) for medical consultation, enabling JF with effective and accurate diagnostic ability. In addition, a Syndrome Agent and a Dual-Stage Retrieval Scheme (DSRS) are developed to significantly enhance the capacity of JF for disease treatment based on syndrome differentiation. JingFang not only facilitates the application of LLMs but also promotes the effective practice of TCM in human health protection and disease treatment.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

Recent advancements in large language models have showcased their remarkable generalizability across various domains. However, their reasoning abilities still have significant room for improvement, especially when confronted with scenarios requiring multi-step reasoning. Although large language models possess extensive knowledge, their behavior, particularly in terms of reasoning, often fails to effectively utilize this knowledge to establish a coherent thinking paradigm. Generative language models sometimes show hallucinations as their reasoning procedures are unconstrained by logical principles. Aiming to improve the zero-shot chain-of-thought reasoning ability of large language models, we propose Logical Chain-of-Thought (LogiCoT), a neurosymbolic framework that leverages principles from symbolic logic to verify and revise the reasoning processes accordingly. Experimental evaluations conducted on language tasks in diverse domains, including arithmetic, commonsense, symbolic, causal inference, and social problems, demonstrate the efficacy of the enhanced reasoning paradigm by logic.

Improving performance on complex tasks and enabling interpretable decision making in large language models (LLMs), especially for clinical applications, requires effective reasoning. Yet this remains challenging without supervised fine-tuning (SFT) on costly chain-of-thought (CoT) data distilled from closed-source models (e.g., GPT-4o). In this work, we present AlphaMed, the first medical LLM to show that reasoning capability can emerge purely through reinforcement learning (RL), using minimalist rule-based rewards on public multiple-choice QA datasets, without relying on SFT or distilled CoT data. AlphaMed achieves state-of-the-art results on six medical QA benchmarks, outperforming models trained with conventional SFT+RL pipelines. On challenging benchmarks (e.g., MedXpert), AlphaMed even surpasses larger or closed-source models such as DeepSeek-V3-671B and Claude-3.5-Sonnet. To understand the factors behind this success, we conduct a comprehensive data-centric analysis guided by three questions: (i) Can minimalist rule-based RL incentivize reasoning without distilled CoT supervision? (ii) How do dataset quantity and diversity impact reasoning? (iii) How does question difficulty shape the emergence and generalization of reasoning? Our findings show that dataset informativeness is a key driver of reasoning performance, and that minimalist RL on informative, multiple-choice QA data is effective at inducing reasoning without CoT supervision. We also observe divergent trends across benchmarks, underscoring limitations in current evaluation and the need for more challenging, reasoning-oriented medical QA benchmarks.

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...

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

Classical self-supervised networks suffer from convergence problems and reduced segmentation accuracy due to forceful termination. Qubits or bi-level quantum bits often describe quantum neural network models. In this article, a novel self-supervised shallow learning network model exploiting the sophisticated three-level qutrit-inspired quantum information system referred to as Quantum Fully Self-Supervised Neural Network (QFS-Net) is presented for automated segmentation of brain MR images. The QFS-Net model comprises a trinity of a layered structure of qutrits inter-connected through parametric Hadamard gates using an 8-connected second-order neighborhood-based topology. The non-linear transformation of the qutrit states allows the underlying quantum neural network model to encode the quantum states, thereby enabling a faster self-organized counter-propagation of these states between the layers without supervision. The suggested QFS-Net model is tailored and extensively validated on Cancer Imaging Archive (TCIA) data set collected from Nature repository and also compared with state of the art supervised (U-Net and URes-Net architectures) and the self-supervised QIS-Net model. Results shed promising segmented outcome in detecting tumors in terms of dice similarity and accuracy with minimum human intervention and computational resources.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

By extending the advantage of chain-of-thought (CoT) reasoning in human-like step-by-step processes to multimodal contexts, multimodal CoT (MCoT) reasoning has recently garnered significant research attention, especially in the integration with multimodal large language models (MLLMs). Existing MCoT studies design various methodologies and innovative reasoning paradigms to address the unique challenges of image, video, speech, audio, 3D, and structured data across different modalities, achieving extensive success in applications such as robotics, healthcare, autonomous driving, and multimodal generation. However, MCoT still presents distinct challenges and opportunities that require further focus to ensure consistent thriving in this field, where, unfortunately, an up-to-date review of this domain is lacking. To bridge this gap, we present the first systematic survey of MCoT reasoning, elucidating the relevant foundational concepts and definitions. We offer a comprehensive taxonomy and an in-depth analysis of current methodologies from diverse perspectives across various application scenarios. Furthermore, we provide insights into existing challenges and future research directions, aiming to foster innovation toward multimodal AGI.

Language models are increasingly being deployed for general problem solving across a wide range of tasks, but are still confined to token-level, left-to-right decision-making processes during inference. This means they can fall short in tasks that require exploration, strategic lookahead, or where initial decisions play a pivotal role. To surmount these challenges, we introduce a new framework for language model inference, Tree of Thoughts (ToT), which generalizes over the popular Chain of Thought approach to prompting language models, and enables exploration over coherent units of text (thoughts) that serve as intermediate steps toward problem solving. ToT allows LMs to perform deliberate decision making by considering multiple different reasoning paths and self-evaluating choices to decide the next course of action, as well as looking ahead or backtracking when necessary to make global choices. Our experiments show that ToT significantly enhances language models' problem-solving abilities on three novel tasks requiring non-trivial planning or search: Game of 24, Creative Writing, and Mini Crosswords. For instance, in Game of 24, while GPT-4 with chain-of-thought prompting only solved 4% of tasks, our method achieved a success rate of 74%. Code repo with all prompts: https://github.com/ysymyth/tree-of-thought-llm.

Recent advancements in reasoning language models have demonstrated remarkable performance in complex tasks, but their extended chain-of-thought reasoning process increases inference overhead. While quantization has been widely adopted to reduce the inference cost of large language models, its impact on reasoning models remains understudied. In this study, we conduct the first systematic study on quantized reasoning models, evaluating the open-sourced DeepSeek-R1-Distilled Qwen and LLaMA families ranging from 1.5B to 70B parameters, and QwQ-32B. Our investigation covers weight, KV cache, and activation quantization using state-of-the-art algorithms at varying bit-widths, with extensive evaluation across mathematical (AIME, MATH-500), scientific (GPQA), and programming (LiveCodeBench) reasoning benchmarks. Our findings reveal that while lossless quantization can be achieved with W8A8 or W4A16 quantization, lower bit-widths introduce significant accuracy risks. We further identify model size, model origin, and task difficulty as critical determinants of performance. Contrary to expectations, quantized models do not exhibit increased output lengths. In addition, strategically scaling the model sizes or reasoning steps can effectively enhance the performance. All quantized models and codes will be open-sourced in https://github.com/ruikangliu/Quantized-Reasoning-Models.

We introduce a novel graph-based Retrieval-Augmented Generation (RAG) framework specifically designed for the medical domain, called MedGraphRAG, aimed at enhancing Large Language Model (LLM) capabilities and generating evidence-based results, thereby improving safety and reliability when handling private medical data. Our comprehensive pipeline begins with a hybrid static-semantic approach to document chunking, significantly improving context capture over traditional methods. Extracted entities are used to create a three-tier hierarchical graph structure, linking entities to foundational medical knowledge sourced from medical papers and dictionaries. These entities are then interconnected to form meta-graphs, which are merged based on semantic similarities to develop a comprehensive global graph. This structure supports precise information retrieval and response generation. The retrieval process employs a U-retrieve method to balance global awareness and indexing efficiency of the LLM. Our approach is validated through a comprehensive ablation study comparing various methods for document chunking, graph construction, and information retrieval. The results not only demonstrate that our hierarchical graph construction method consistently outperforms state-of-the-art models on multiple medical Q\&A benchmarks, but also confirms that the responses generated include source documentation, significantly enhancing the reliability of medical LLMs in practical applications. Code will be at: https://github.com/MedicineToken/Medical-Graph-RAG/tree/main

Iterative human engagement is a common and effective means of leveraging the advanced language processing power of large language models (LLMs). Using well-structured prompts in a conversational manner, human users can effectively influence an LLM to develop more thoughtful and accurate responses. Motivated by this insight, we propose the Iteration of Thought (IoT) framework for enhancing LLM responses by generating "thought"-provoking prompts vis a vis an input query and the current iteration of an LLM's response. Unlike static or semi-static approaches, e.g. Chain of Thought (CoT) or Tree of Thoughts (ToT), IoT adapts its reasoning path dynamically, based on evolving context, and without generating alternate explorative thoughts which are ultimately discarded. The three components of the IoT framework are (1) an Inner Dialogue Agent (IDA) responsible for generating instructive, context-specific prompts; (2) an LLM Agent (LLMA) that processes these prompts to refine its responses; and (3) an iterative prompting loop that implements a conversation between the former two components. We introduce two variants of our framework: Autonomous Iteration of Thought (AIoT), where an LLM decides when to stop iterating, and Guided Iteration of Thought (GIoT), which always forces a fixed number iterations. We investigate the performance of IoT across various datasets, spanning complex reasoning tasks from the GPQA dataset, explorative problem-solving in Game of 24, puzzle solving in Mini Crosswords, and multi-hop question answering from the HotpotQA dataset. Our results show that IoT represents a viable paradigm for autonomous response refinement in LLMs, showcasing significant improvements over CoT and thereby enabling more adaptive and efficient reasoning systems that minimize human intervention.

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

While recent advancements in commercial large language models (LM) have shown promising results in medical tasks, their closed-source nature poses significant privacy and security concerns, hindering their widespread use in the medical field. Despite efforts to create open-source models, their limited parameters often result in insufficient multi-step reasoning capabilities required for solving complex medical problems. To address this, we introduce Meerkat-7B, a novel medical AI system with 7 billion parameters. Meerkat-7B was trained using our new synthetic dataset consisting of high-quality chain-of-thought reasoning paths sourced from 18 medical textbooks, along with diverse instruction-following datasets. Our system achieved remarkable accuracy across seven medical benchmarks, surpassing GPT-3.5 by 13.1%, as well as outperforming the previous best 7B models such as MediTron-7B and BioMistral-7B by 13.4% and 9.8%, respectively. Notably, it surpassed the passing threshold of the United States Medical Licensing Examination (USMLE) for the first time for a 7B-parameter model. Additionally, our system offered more detailed free-form responses to clinical queries compared to existing 7B and 13B models, approaching the performance level of GPT-3.5. This significantly narrows the performance gap with large LMs, showcasing its effectiveness in addressing complex medical challenges.

While deep networks have achieved broad success in analyzing natural images, when applied to medical scans, they often fail in unexcepted situations. We investigate this challenge and focus on model sensitivity to domain shifts, such as data sampled from different hospitals or data confounded by demographic variables such as sex, race, etc, in the context of chest X-rays and skin lesion images. A key finding we show empirically is that existing visual backbones lack an appropriate prior from the architecture for reliable generalization in these settings. Taking inspiration from medical training, we propose giving deep networks a prior grounded in explicit medical knowledge communicated in natural language. To this end, we introduce Knowledge-enhanced Bottlenecks (KnoBo), a class of concept bottleneck models that incorporates knowledge priors that constrain it to reason with clinically relevant factors found in medical textbooks or PubMed. KnoBo uses retrieval-augmented language models to design an appropriate concept space paired with an automatic training procedure for recognizing the concept. We evaluate different resources of knowledge and recognition architectures on a broad range of domain shifts across 20 datasets. In our comprehensive evaluation with two imaging modalities, KnoBo outperforms fine-tuned models on confounded datasets by 32.4% on average. Finally, evaluations reveal that PubMed is a promising resource for making medical models less sensitive to domain shift, outperforming other resources on both diversity of information and final prediction performance.

Recent advancements in Large Language Models (LLMs) have revolutionized decision-making by breaking down complex problems into more manageable language sequences referred to as ``thoughts''. An effective thought design should consider three key perspectives: performance, efficiency, and flexibility. However, existing thought can at most exhibit two of these attributes. To address these limitations, we introduce a novel thought prompting approach called ``Everything of Thoughts'' (XoT) to defy the law of ``Penrose triangle of existing thought paradigms. XoT leverages pretrained reinforcement learning and Monte Carlo Tree Search (MCTS) to incorporate external domain knowledge into thoughts, thereby enhancing LLMs' capabilities and enabling them to generalize to unseen problems efficiently. Through the utilization of the MCTS-LLM collaborative thought revision framework, this approach autonomously produces high-quality comprehensive cognitive mappings with minimal LLM interactions. Additionally, XoT empowers LLMs to engage in unconstrained thinking, allowing for flexible cognitive mappings for problems with multiple solutions.

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

Large language models (LLMs) are capable of answering knowledge-intensive complex questions with chain-of-thought (CoT) reasoning. However, they tend to generate factually incorrect reasoning steps when the required knowledge is not available or up-to-date in models' parameters. Recent works turn to retrieving external knowledge to augment CoT reasoning. Despite being promising, these chain-based methods suffer from: 1) Negative retrieval. Unnecessary or incorrect retrieval may mislead the reasoning; 2) Limited sight. Lacking the ability to look backward or forward, a local error in one step will propagate along the chain. In this paper, we propose a novel approach: Probabilistic Tree-of-thought Reasoning (ProbTree). First, LLMs translate a complex question into a query tree, in which each non-root node denotes a sub-question of its parent node. Then, probabilistic reasoning is conducted over the tree, by solving questions from leaf to root considering the confidence of both question decomposing and answering. During reasoning, for leaf nodes, LLMs choose a more confident answer from Closed-book QA that employs parametric knowledge and Open-book QA that employs retrieved external knowledge, thus eliminating the negative retrieval problem. For non-leaf nodes, with the hierarchical structure, LLMs have broader sights and are able to globally reason with the information from child nodes, thus recovering from local errors. The experiments on three Complex QA datasets under the open-domain setting show that our approach outperforms SOTA methods significantly, demonstrating the effect of probabilistic tree-of-thought reasoning.

Generating Natural Language Explanations (NLEs) for model predictions on medical images, particularly those depicting thoracic pathologies, remains a critical and challenging task. Existing methodologies often struggle due to general models' insufficient domain-specific medical knowledge and privacy concerns associated with retrieval-based augmentation techniques. To address these issues, we propose a novel Vision-Language framework augmented with a Knowledge Graph (KG)-based datastore, which enhances the model's understanding by incorporating additional domain-specific medical knowledge essential for generating accurate and informative NLEs. Our framework employs a KG-based retrieval mechanism that not only improves the precision of the generated explanations but also preserves data privacy by avoiding direct data retrieval. The KG datastore is designed as a plug-and-play module, allowing for seamless integration with various model architectures. We introduce and evaluate three distinct frameworks within this paradigm: KG-LLaVA, which integrates the pre-trained LLaVA model with KG-RAG; Med-XPT, a custom framework combining MedCLIP, a transformer-based projector, and GPT-2; and Bio-LLaVA, which adapts LLaVA by incorporating the Bio-ViT-L vision model. These frameworks are validated on the MIMIC-NLE dataset, where they achieve state-of-the-art results, underscoring the effectiveness of KG augmentation in generating high-quality NLEs for thoracic pathologies.

The rapid advancement of large language models (LLMs) has significantly impacted various domains, including healthcare and biomedicine. However, the phenomenon of hallucination, where LLMs generate outputs that deviate from factual accuracy or context, poses a critical challenge, especially in high-stakes domains. This paper conducts a scoping study of existing techniques for mitigating hallucinations in knowledge-based task in general and especially for medical domains. Key methods covered in the paper include Retrieval-Augmented Generation (RAG)-based techniques, iterative feedback loops, supervised fine-tuning, and prompt engineering. These techniques, while promising in general contexts, require further adaptation and optimization for the medical domain due to its unique demands for up-to-date, specialized knowledge and strict adherence to medical guidelines. Addressing these challenges is crucial for developing trustworthy AI systems that enhance clinical decision-making and patient safety as well as accuracy of biomedical scientific research.

Numerous applications of large language models (LLMs) rely on their ability to perform step-by-step reasoning. However, the reasoning behavior of LLMs remains poorly understood, posing challenges to research, development, and safety. To address this gap, we introduce landscape of thoughts-the first visualization tool for users to inspect the reasoning paths of chain-of-thought and its derivatives on any multi-choice dataset. Specifically, we represent the states in a reasoning path as feature vectors that quantify their distances to all answer choices. These features are then visualized in two-dimensional plots using t-SNE. Qualitative and quantitative analysis with the landscape of thoughts effectively distinguishes between strong and weak models, correct and incorrect answers, as well as different reasoning tasks. It also uncovers undesirable reasoning patterns, such as low consistency and high uncertainty. Additionally, users can adapt our tool to a model that predicts the property they observe. We showcase this advantage by adapting our tool to a lightweight verifier that evaluates the correctness of reasoning paths. The code is publicly available at: https://github.com/tmlr-group/landscape-of-thoughts.

Humans can develop internal world models that encode common sense knowledge, telling them how the world works and predicting the consequences of their actions. This concept has emerged as a promising direction for establishing general-purpose machine-learning models in recent preliminary works, e.g., for visual representation learning. In this paper, we present CheXWorld, the first effort towards a self-supervised world model for radiographic images. Specifically, our work develops a unified framework that simultaneously models three aspects of medical knowledge essential for qualified radiologists, including 1) local anatomical structures describing the fine-grained characteristics of local tissues (e.g., architectures, shapes, and textures); 2) global anatomical layouts describing the global organization of the human body (e.g., layouts of organs and skeletons); and 3) domain variations that encourage CheXWorld to model the transitions across different appearance domains of radiographs (e.g., varying clarity, contrast, and exposure caused by collecting radiographs from different hospitals, devices, or patients). Empirically, we design tailored qualitative and quantitative analyses, revealing that CheXWorld successfully captures these three dimensions of medical knowledge. Furthermore, transfer learning experiments across eight medical image classification and segmentation benchmarks showcase that CheXWorld significantly outperforms existing SSL methods and large-scale medical foundation models. Code & pre-trained models are available at https://github.com/LeapLabTHU/CheXWorld.

The recent development of chain-of-thought (CoT) decoding has enabled large language models (LLMs) to generate explicit logical reasoning paths for complex problem-solving. However, research indicates that these paths are not always deliberate and optimal. The tree-of-thought (ToT) method employs tree-searching to extensively explore the reasoning space and find better reasoning paths that CoT decoding might overlook. This deliberation, however, comes at the cost of significantly increased inference complexity. In this work, we demonstrate that fine-tuning LLMs leveraging the search tree constructed by ToT allows CoT to achieve similar or better performance, thereby avoiding the substantial inference burden. This is achieved through Chain of Preference Optimization (CPO), where LLMs are fine-tuned to align each step of the CoT reasoning paths with those of ToT using the inherent preference information in the tree-search process. Extensive experimental results show that CPO significantly improves LLM performance in solving a variety of complex problems, including question answering, fact verification, and arithmetic reasoning, demonstrating its effectiveness. Our code is available at https://github.com/sail-sg/CPO.

Reasoning ability is one of the most crucial capabilities of a foundation model, signifying its capacity to address complex reasoning tasks. Chain-of-Thought (CoT) technique is widely regarded as one of the effective methods for enhancing the reasoning ability of foundation models and has garnered significant attention. However, the reasoning process of CoT is linear, step-by-step, similar to personal logical reasoning, suitable for solving general and slightly complicated problems. On the contrary, the thinking pattern of an expert owns two prominent characteristics that cannot be handled appropriately in CoT, i.e., high-order multi-hop reasoning and multimodal comparative judgement. Therefore, the core motivation of this paper is transcending CoT to construct a reasoning paradigm that can think like an expert. The hyperedge of a hypergraph could connect various vertices, making it naturally suitable for modelling high-order relationships. Inspired by this, this paper innovatively proposes a multimodal Hypergraph-of-Thought (HoT) reasoning paradigm, which enables the foundation models to possess the expert-level ability of high-order multi-hop reasoning and multimodal comparative judgement. Specifically, a textual hypergraph-of-thought is constructed utilizing triple as the primary thought to model higher-order relationships, and a hyperedge-of-thought is generated through multi-hop walking paths to achieve multi-hop inference. Furthermore, we devise a visual hypergraph-of-thought to interact with the textual hypergraph-of-thought via Cross-modal Co-Attention Graph Learning for multimodal comparative verification. Experimentations on the ScienceQA benchmark demonstrate the proposed HoT-based T5 outperforms CoT-based GPT3.5 and chatGPT, which is on par with CoT-based GPT4 with a lower model size.

In this paper, we address the challenging task of multimodal mathematical reasoning by incorporating the ability of "slow thinking" into multimodal large language models (MLLMs). Our core idea is that different levels of reasoning abilities can be combined dynamically to tackle questions with different complexity. To this end, we propose a paradigm of Self-structured Chain of Thought (SCoT), which is composed of minimal semantic atomic steps. Different from existing methods that rely on structured templates or free-form paradigms, our method can not only generate cognitive CoT structures for various complex tasks but also mitigates the phenomenon of overthinking. To introduce structured reasoning capabilities into visual understanding models, we further design a novel AtomThink framework with four key modules, including (i) a data engine to generate high-quality multimodal reasoning paths; (ii) a supervised fine-tuning process with serialized inference data; (iii) a policy-guided multi-turn inference method; and (iv) an atomic capability metric to evaluate the single step utilization rate. We conduct extensive experiments to show that the proposed AtomThink significantly improves the performance of baseline MLLMs, achieving more than 10\% average accuracy gains on MathVista and MathVerse. Compared to state-of-the-art structured CoT approaches, our method not only achieves higher accuracy but also improves data utilization by 5 times and boosts inference efficiency by 85.3\%. Our code is now public available in https://github.com/Quinn777/AtomThink.

Medical Dialogue Generation serves a critical role in telemedicine by facilitating the dissemination of medical expertise to patients. Existing studies focus on incorporating textual representations, which have limited their ability to represent the semantics of text, such as ignoring important medical entities. To enhance the model's understanding of the textual semantics and the medical knowledge including entities and relations, we introduce the use of Abstract Meaning Representations (AMR) to construct graphical representations that delineate the roles of language constituents and medical entities within the dialogues. In this paper, We propose a novel framework that models dialogues between patients and healthcare professionals using AMR graphs, where the neural networks incorporate textual and graphical knowledge with a dual attention mechanism. Experimental results show that our framework outperforms strong baseline models in medical dialogue generation, demonstrating the effectiveness of AMR graphs in enhancing the representations of medical knowledge and logical relationships. Furthermore, to support future research in this domain, we provide the corresponding source code at https://github.com/Bernard-Yang/MedDiaAMR.

Large Language Models (LLMs) have revolutionized natural language processing and hold immense potential for advancing Artificial Intelligence. However, the core architecture of most mainstream LLMs -- the Transformer -- has inherent limitations in computational depth, rendering them theoretically incapable of solving many reasoning tasks that demand increasingly deep computations. Chain of Thought (CoT) prompting has emerged as a technique to address these architectural limitations, as evidenced by several theoretical studies. It offers a promising approach to solving complex reasoning tasks that were previously beyond the capabilities of these models. Despite its successes, CoT and its variants (such as Tree of Thought, Graph of Thought, etc.) rely on a "one-prompt-for-all" approach, using a single prompt structure (e.g., "think step by step") for a wide range of tasks -- from counting and sorting to solving mathematical and algorithmic problems. This approach poses significant challenges for models to generate the correct reasoning steps, as the model must navigate through a vast prompt template space to find the appropriate template for each task. In this work, we build upon previous theoretical analyses of CoT to demonstrate how the one-prompt-for-all approach can negatively affect the computability of LLMs. We partition the solution search space into two: the prompt space and the answer space. Our findings show that task-specific supervision is essential for navigating the prompt space accurately and achieving optimal performance. Through experiments with state-of-the-art LLMs, we reveal a gap in reasoning performance when supervision is applied versus when it is not.

Instructing the model to generate a sequence of intermediate steps, a.k.a., a chain of thought (CoT), is a highly effective method to improve the accuracy of large language models (LLMs) on arithmetics and symbolic reasoning tasks. However, the mechanism behind CoT remains unclear. This work provides a theoretical understanding of the power of CoT for decoder-only transformers through the lens of expressiveness. Conceptually, CoT empowers the model with the ability to perform inherently serial computation, which is otherwise lacking in transformers, especially when depth is low. Given input length n, previous works have shown that constant-depth transformers with finite precision poly(n) embedding size can only solve problems in TC^0 without CoT. We first show an even tighter expressiveness upper bound for constant-depth transformers with constant-bit precision, which can only solve problems in AC^0, a proper subset of TC^0. However, with T steps of CoT, constant-depth transformers using constant-bit precision and O(log n) embedding size can solve any problem solvable by boolean circuits of size T. Empirically, enabling CoT dramatically improves the accuracy for tasks that are hard for parallel computation, including the composition of permutation groups, iterated squaring, and circuit value problems, especially for low-depth transformers.

Recent advances such as Chain-of-Thought prompting have significantly improved large language models (LLMs) in zero-shot medical reasoning. However, prompting-based methods often remain shallow and unstable, while fine-tuned medical LLMs suffer from poor generalization under distribution shifts and limited adaptability to unseen clinical scenarios. To address these limitations, we present TAGS, a test-time framework that combines a broadly capable generalist with a domain-specific specialist to offer complementary perspectives without any model fine-tuning or parameter updates. To support this generalist-specialist reasoning process, we introduce two auxiliary modules: a hierarchical retrieval mechanism that provides multi-scale exemplars by selecting examples based on both semantic and rationale-level similarity, and a reliability scorer that evaluates reasoning consistency to guide final answer aggregation. TAGS achieves strong performance across nine MedQA benchmarks, boosting GPT-4o accuracy by 13.8%, DeepSeek-R1 by 16.8%, and improving a vanilla 7B model from 14.1% to 23.9%. These results surpass several fine-tuned medical LLMs, without any parameter updates. The code will be available at https://github.com/JianghaoWu/TAGS.

While chain-of-thought (CoT) prompting has revolutionized how LLMs perform reasoning tasks, its current methods and variations (e.g, Self-consistency, ReACT, Reflexion, Tree-of-Thoughts (ToT), Cumulative Reasoning (CR)) suffer from limitations like slowness, limited context grounding, hallucination and inconsistent outputs. To overcome these challenges, we introduce Evidence to Generate (E2G), a novel single-agent, two-step prompting framework. Instead of unverified reasoning claims, this innovative approach leverages the power of "evidence for decision making" by first focusing exclusively on the thought sequences (the series of intermediate steps) explicitly mentioned in the context which then serve as extracted evidence, guiding the LLM's output generation process with greater precision and efficiency. This simple yet powerful approach unlocks the true potential of chain-of-thought like prompting, paving the way for faster, more reliable, and more contextually aware reasoning in LLMs. \tool achieves remarkable results robustly across a wide range of knowledge-intensive reasoning and generation tasks, surpassing baseline approaches with state-of-the-art LLMs. For example, (i) on LogiQA benchmark using GPT-4 as backbone model, \tool achieves a new state-of-the Accuracy of 53.8% exceeding CoT by 18%, ToT by 11%, CR by 9% (ii) a variant of E2G with PaLM2 outperforms the variable-shot performance of Gemini Ultra by 0.9 F1 points, reaching an F1 score of 83.3 on a subset of DROP.

Large language models (LLMs), particularly those with reasoning capabilities, have rapidly advanced in recent years, demonstrating significant potential across a wide range of applications. However, their deployment in healthcare, especially in disease reasoning tasks, is hindered by the challenge of acquiring expert-level cognitive data. In this paper, we introduce Citrus, a medical language model that bridges the gap between clinical expertise and AI reasoning by emulating the cognitive processes of medical experts. The model is trained on a large corpus of simulated expert disease reasoning data, synthesized using a novel approach that accurately captures the decision-making pathways of clinicians. This approach enables Citrus to better simulate the complex reasoning processes involved in diagnosing and treating medical conditions.To further address the lack of publicly available datasets for medical reasoning tasks, we release the last-stage training data, including a custom-built medical diagnostic dialogue dataset. This open-source contribution aims to support further research and development in the field. Evaluations using authoritative benchmarks such as MedQA, covering tasks in medical reasoning and language understanding, show that Citrus achieves superior performance compared to other models of similar size. These results highlight Citrus potential to significantly enhance medical decision support systems, providing a more accurate and efficient tool for clinical decision-making.

In recent advancements, multimodal large language models (MLLMs) have been fine-tuned on specific medical image datasets to address medical visual question answering (Med-VQA) tasks. However, this common approach of task-specific fine-tuning is costly and necessitates separate models for each downstream task, limiting the exploration of zero-shot capabilities. In this paper, we introduce MC-CoT, a modular cross-modal collaboration Chain-of-Thought (CoT) framework designed to enhance the zero-shot performance of MLLMs in Med-VQA by leveraging large language models (LLMs). MC-CoT improves reasoning and information extraction by integrating medical knowledge and task-specific guidance, where LLM provides various complex medical reasoning chains and MLLM provides various observations of medical images based on instructions of the LLM. Our experiments on datasets such as SLAKE, VQA-RAD, and PATH-VQA show that MC-CoT surpasses standalone MLLMs and various multimodality CoT frameworks in recall rate and accuracy. These findings highlight the importance of incorporating background information and detailed guidance in addressing complex zero-shot Med-VQA tasks.

Chain of Thought (CoT) of multi-step benefits from the logical structure of the reasoning steps and task-specific actions, significantly enhancing the mathematical reasoning capabilities of large language models. As the prevalence of long CoT, the number of reasoning steps exceeds manageable token limits and leads to higher computational demands. Inspired by the fundamental logic of human cognition, ``derive, then reduce'', we conceptualize the standard multi-step CoT as a novel Markov Chain of Thought (MCoT). In this study, we consider the mathematical reasoning task, defining each reasoning step as text accompanied by a Python code snippet. To facilitate a longer reasoning path, self-correction is enabled through interactions with the code interpreter. Our MCoT aims to compress previous reasoning steps into a simplified question, enabling efficient next-step inference without relying on a lengthy KV cache. In our experiments, we curate the MCoTInstruct dataset, and the empirical results indicate that MCoT not only significantly enhances efficiency but also maintains comparable accuracy. While much remains to be explored, this work paves the way for exploring the long CoT reasoning abilities of LLMs.

While there have been extensive studies in code generation by large language models (LLM), where benchmarks like HumanEval have been surpassed with an impressive 96.3% success rate, these benchmarks predominantly judge a model's performance on basic function-level code generation and lack the critical thinking and concept of scope required of real-world scenarios such as solving GitHub issues. This research introduces the application of the Tree of Thoughts (ToT) language model reasoning framework for enhancing the decision-making and problem-solving abilities of LLMs for this complex task. Compared to traditional input-output (IO) prompting and Retrieval Augmented Generation (RAG) techniques, ToT is designed to improve performance by facilitating a structured exploration of multiple reasoning trajectories and enabling self-assessment of potential solutions. We experimentally deploy ToT in tackling a Github issue contained within an instance of the SWE-bench. However, our results reveal that the ToT framework alone is not enough to give LLMs the critical reasoning capabilities to outperform existing methods. In this paper we analyze the potential causes of these shortcomings and identify key areas for improvement such as deepening the thought process and introducing agentic capabilities. The insights of this research are aimed at informing future directions for refining the application of ToT and better harnessing the potential of LLMs in real-world problem-solving scenarios.

Large language models (LLMs) have been routinely used to solve various tasks using step-by-step reasoning. However, the structure of intermediate reasoning steps, or thoughts, is rigid and unidirectional, such as chains, trees, or acyclic-directed graphs. Consequently, the resulting inflexible and forward-only reasoning may not address challenging tasks and fail when the LLM frequently gives false responses, i.e., ``hallucinations''. This paper proposes a new reasoning framework, called Thought Rollback (TR), allowing LLMs to adaptively build thought structure while maintaining effective reasoning toward problem-solving under ``hallucinations''. The core mechanism of TR is rolling back thoughts, which allows LLMs to perform error analysis on thoughts, and thus roll back to any previously mistaken thought for revision. Subsequently, by including such trial-and-error in the prompt to guide the LLM, each rollback leads to one more reliable reasoning path. Therefore, starting with a simple prompt without human annotations, LLM with TR adaptively and gradually explores thoughts for a correct solution. Comprehensive experiments on mathematical problems and multi-task reasoning demonstrate the state-of-the-art performance of TR in terms of problem-solving rate and interaction cost. For instance, the solving rate of GPT-4 with TR outperforms the current best by 9% on the MATH dataset.

Equipped with Chain-of-Thought (CoT), Large language models (LLMs) have shown impressive reasoning ability in various downstream tasks. Even so, suffering from hallucinations and the inability to access external knowledge, LLMs often come with incorrect or unfaithful intermediate reasoning steps, especially in the context of answering knowledge-intensive tasks such as KBQA. To alleviate this issue, we propose a framework called Knowledge-Driven Chain-of-Thought (KD-CoT) to verify and modify reasoning traces in CoT via interaction with external knowledge, and thus overcome the hallucinations and error propagation. Concretely, we formulate the CoT rationale process of LLMs into a structured multi-round QA format. In each round, LLMs interact with a QA system that retrieves external knowledge and produce faithful reasoning traces based on retrieved precise answers. The structured CoT reasoning of LLMs is facilitated by our developed KBQA CoT collection, which serves as in-context learning demonstrations and can also be utilized as feedback augmentation to train a robust retriever. Extensive experiments on WebQSP and ComplexWebQuestion datasets demonstrate the effectiveness of proposed KD-CoT in task-solving reasoning generation, which outperforms the vanilla CoT ICL with an absolute success rate of 8.0% and 5.1%. Furthermore, our proposed feedback-augmented retriever outperforms the state-of-the-art baselines for retrieving knowledge, achieving significant improvement in Hit performance.

We present MedHal, a novel large-scale dataset specifically designed to evaluate if models can detect hallucinations in medical texts. Current hallucination detection methods face significant limitations when applied to specialized domains like medicine, where they can have disastrous consequences. Existing medical datasets are either too small, containing only a few hundred samples, or focus on a single task like Question Answering or Natural Language Inference. MedHal addresses these gaps by: (1) incorporating diverse medical text sources and tasks; (2) providing a substantial volume of annotated samples suitable for training medical hallucination detection models; and (3) including explanations for factual inconsistencies to guide model learning. We demonstrate MedHal's utility by training and evaluating a baseline medical hallucination detection model, showing improvements over general-purpose hallucination detection approaches. This resource enables more efficient evaluation of medical text generation systems while reducing reliance on costly expert review, potentially accelerating the development of medical AI research.

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

When presented with questions involving visual thinking, humans naturally switch reasoning modalities, often forming mental images or drawing visual aids. Large language models have shown promising results in arithmetic and symbolic reasoning by expressing intermediate reasoning in text as a chain of thought, yet struggle to extend this capability to answer text queries that are easily solved by visual reasoning, even with extensive multimodal pretraining. We introduce a simple method, whiteboard-of-thought prompting, to unlock the visual reasoning capabilities of multimodal large language models across modalities. Whiteboard-of-thought prompting provides multimodal large language models with a metaphorical `whiteboard' to draw out reasoning steps as images, then returns these images back to the model for further processing. We find this can be accomplished with no demonstrations or specialized modules, instead leveraging models' existing ability to write code with libraries such as Matplotlib and Turtle. This simple approach shows state-of-the-art results on four difficult natural language tasks that involve visual and spatial reasoning. We identify multiple settings where GPT-4o using chain-of-thought fails dramatically, including more than one where it achieves 0% accuracy, while whiteboard-of-thought enables up to 92% accuracy in these same settings. We present a detailed exploration of where the technique succeeds as well as its sources of error.

Chain-of-Thought (CoT) prompting enhances the reasoning of large language models (LLMs) by decomposing problems into sequential steps, mimicking human logic and reducing errors. However, complex tasks with vast solution spaces and vague constraints often exceed the capacity of a single reasoning chain. Inspired by Minimal Free Resolution (MFR) in commutative algebra and algebraic geometry, we propose Syzygy of Thoughts (SoT)-a novel framework that extends CoT by introducing auxiliary, interrelated reasoning paths. SoT captures deeper logical dependencies, enabling more robust and structured problem-solving. MFR decomposes a module into a sequence of free modules with minimal rank, providing a structured analytical approach to complex systems. This method introduces the concepts of "Module", "Betti numbers","Freeness", "Mapping", "Exactness" and "Minimality", enabling the systematic decomposition of the original complex problem into logically complete minimal subproblems while preserving key problem features and reducing reasoning length. We tested SoT across diverse datasets (e.g., GSM8K, MATH) and models (e.g., GPT-4o-mini, Qwen2.5), achieving inference accuracy that matches or surpasses mainstream CoTs standards. Additionally, by aligning the sampling process with algebraic constraints, our approach enhances the scalability of inference time in LLMs, ensuring both transparent reasoning and high performance. Our code will be publicly available at https://github.com/dlMARiA/Syzygy-of-thoughts.

In this paper, we introduce the Tree-of-Thought (ToT) framework, a novel approach aimed at improving the problem-solving capabilities of auto-regressive large language models (LLMs). The ToT technique is inspired by the human mind's approach for solving complex reasoning tasks through trial and error. In this process, the human mind explores the solution space through a tree-like thought process, allowing for backtracking when necessary. To implement ToT as a software system, we augment an LLM with additional modules including a prompter agent, a checker module, a memory module, and a ToT controller. In order to solve a given problem, these modules engage in a multi-round conversation with the LLM. The memory module records the conversation and state history of the problem solving process, which allows the system to backtrack to the previous steps of the thought-process and explore other directions from there. To verify the effectiveness of the proposed technique, we implemented a ToT-based solver for the Sudoku Puzzle. Experimental results show that the ToT framework can significantly increase the success rate of Sudoku puzzle solving. Our implementation of the ToT-based Sudoku solver is available on GitHub: https://github.com/jieyilong/tree-of-thought-puzzle-solver.

Human cognition typically involves thinking through abstract, fluid concepts rather than strictly using discrete linguistic tokens. Current reasoning models, however, are constrained to reasoning within the boundaries of human language, processing discrete token embeddings that represent fixed points in the semantic space. This discrete constraint restricts the expressive power and upper potential of such reasoning models, often causing incomplete exploration of reasoning paths, as standard Chain-of-Thought (CoT) methods rely on sampling one token per step. In this work, we introduce Soft Thinking, a training-free method that emulates human-like "soft" reasoning by generating soft, abstract concept tokens in a continuous concept space. These concept tokens are created by the probability-weighted mixture of token embeddings, which form the continuous concept space, enabling smooth transitions and richer representations that transcend traditional discrete boundaries. In essence, each generated concept token encapsulates multiple meanings from related discrete tokens, implicitly exploring various reasoning paths to converge effectively toward the correct answer. Empirical evaluations on diverse mathematical and coding benchmarks consistently demonstrate the effectiveness and efficiency of Soft Thinking, improving pass@1 accuracy by up to 2.48 points while simultaneously reducing token usage by up to 22.4% compared to standard CoT. Qualitative analysis further reveals that Soft Thinking outputs remain highly interpretable and readable, highlighting the potential of Soft Thinking to break the inherent bottleneck of discrete language-based reasoning. Code is available at https://github.com/eric-ai-lab/Soft-Thinking.

Compressing long chain-of-thought (CoT) from large language models (LLMs) is an emerging strategy to improve the reasoning efficiency of LLMs. Despite its promising benefits, existing studies equally compress all thoughts within a long CoT, hindering more concise and effective reasoning. To this end, we first investigate the importance of different thoughts by examining their effectiveness and efficiency in contributing to reasoning through automatic long CoT chunking and Monte Carlo rollouts. Building upon the insights, we propose a theoretically bounded metric to jointly measure the effectiveness and efficiency of different thoughts. We then propose LongotimesShort, an efficient reasoning framework that enables two LLMs to collaboratively solve the problem: a long-thought LLM for more effectively generating important thoughts, while a short-thought LLM for efficiently generating remaining thoughts. Specifically, we begin by synthesizing a small amount of cold-start data to fine-tune LLMs for long-thought and short-thought reasoning styles, respectively. Furthermore, we propose a synergizing-oriented multi-turn reinforcement learning, focusing on the model self-evolution and collaboration between long-thought and short-thought LLMs. Experimental results show that our method enables Qwen2.5-7B and Llama3.1-8B to achieve comparable performance compared to DeepSeek-R1-Distill-Qwen-7B and DeepSeek-R1-Distill-Llama-8B, while reducing token length by over 80% across the MATH500, AIME24/25, AMC23, and GPQA Diamond benchmarks. Our data and code are available at https://github.com/yasNing/Long-otimes-Short/.

Medical Visual Question Answering (Med-VQA) answers clinical questions using medical images, aiding diagnosis. Designing the MedVQA system holds profound importance in assisting clinical diagnosis and enhancing diagnostic accuracy. Building upon this foundation, Hierarchical Medical VQA extends Medical VQA by organizing medical questions into a hierarchical structure and making level-specific predictions to handle fine-grained distinctions. Recently, many studies have proposed hierarchical MedVQA tasks and established datasets, However, several issues still remain: (1) imperfect hierarchical modeling leads to poor differentiation between question levels causing semantic fragmentation across hierarchies. (2) Excessive reliance on implicit learning in Transformer-based cross-modal self-attention fusion methods, which obscures crucial local semantic correlations in medical scenarios. To address these issues, this study proposes a HiCA-VQA method, including two modules: Hierarchical Prompting for fine-grained medical questions and Hierarchical Answer Decoders. The hierarchical prompting module pre-aligns hierarchical text prompts with image features to guide the model in focusing on specific image regions according to question types, while the hierarchical decoder performs separate predictions for questions at different levels to improve accuracy across granularities. The framework also incorporates a cross-attention fusion module where images serve as queries and text as key-value pairs. Experiments on the Rad-Restruct benchmark demonstrate that the HiCA-VQA framework better outperforms existing state-of-the-art methods in answering hierarchical fine-grained questions. This study provides an effective pathway for hierarchical visual question answering systems, advancing medical image understanding.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Chain-of-Thought (CoT) has been a widely adopted prompting method, eliciting impressive reasoning abilities of Large Language Models (LLMs). Inspired by the sequential thought structure of CoT, a number of Chain-of-X (CoX) methods have been developed to address various challenges across diverse domains and tasks involving LLMs. In this paper, we provide a comprehensive survey of Chain-of-X methods for LLMs in different contexts. Specifically, we categorize them by taxonomies of nodes, i.e., the X in CoX, and application tasks. We also discuss the findings and implications of existing CoX methods, as well as potential future directions. Our survey aims to serve as a detailed and up-to-date resource for researchers seeking to apply the idea of CoT to broader scenarios.

Vision-language models (VLMs) have advanced reasoning in natural scenes, but their role in medical imaging remains underexplored. Medical reasoning tasks demand robust image analysis and well-justified answers, posing challenges due to the complexity of medical images. Transparency and trustworthiness are essential for clinical adoption and regulatory compliance. We introduce Med-R1, a framework exploring reinforcement learning (RL) to enhance VLMs' generalizability and trustworthiness in medical reasoning. Leveraging the DeepSeek strategy, we employ Group Relative Policy Optimization (GRPO) to guide reasoning paths via reward signals. Unlike supervised fine-tuning (SFT), which often overfits and lacks generalization, RL fosters robust and diverse reasoning. Med-R1 is evaluated across eight medical imaging modalities: CT, MRI, Ultrasound, Dermoscopy, Fundus Photography, Optical Coherence Tomography (OCT), Microscopy, and X-ray Imaging. Compared to its base model, Qwen2-VL-2B, Med-R1 achieves a 29.94% accuracy improvement and outperforms Qwen2-VL-72B, which has 36 times more parameters. Testing across five question types-modality recognition, anatomy identification, disease diagnosis, lesion grading, and biological attribute analysis Med-R1 demonstrates superior generalization, exceeding Qwen2-VL-2B by 32.06% and surpassing Qwen2-VL-72B in question-type generalization. These findings show that RL improves medical reasoning and enables parameter-efficient models to outperform significantly larger ones. With interpretable reasoning outputs, Med-R1 represents a promising step toward generalizable, trustworthy, and clinically viable medical VLMs.

Large Language Models (LLMs) constitute a breakthrough state-of-the-art Artificial Intelligence (AI) technology which is rapidly evolving and promises to aid in medical diagnosis either by assisting doctors or by simulating a doctor's workflow in more advanced and complex implementations. In this technical paper, we outline Cognitive Network Evaluation Toolkit for Medical Domains (COGNET-MD), which constitutes a novel benchmark for LLM evaluation in the medical domain. Specifically, we propose a scoring-framework with increased difficulty to assess the ability of LLMs in interpreting medical text. The proposed framework is accompanied with a database of Multiple Choice Quizzes (MCQs). To ensure alignment with current medical trends and enhance safety, usefulness, and applicability, these MCQs have been constructed in collaboration with several associated medical experts in various medical domains and are characterized by varying degrees of difficulty. The current (first) version of the database includes the medical domains of Psychiatry, Dentistry, Pulmonology, Dermatology and Endocrinology, but it will be continuously extended and expanded to include additional medical domains.

Research on LLM technologies is rapidly emerging, with most of them employing a 'fast thinking' approach to inference. Most LLMs generate the final result based solely on a single query and LLM's reasoning capabilities. However, with the advent of OpenAI-o1, 'slow thinking' techniques have garnered increasing attention because its process is closer to the human thought process. Inspired by the human ability to constantly associate and replenish knowledge during thinking, we developed the novel Chain-of-Associated-Thoughts (CoAT) framework, which introduces an innovative synergy between the Monte Carlo Tree Search (MCTS) algorithm and a dynamic mechanism for integrating new key information, termed 'associative memory'. By combining the structured exploration capabilities of MCTS with the adaptive learning capacity of associative memory, CoAT significantly expands the LLM search space, enabling our framework to explore diverse reasoning pathways and dynamically update its knowledge base in real-time. This allows the framework to not only revisit and refine earlier inferences but also adaptively incorporate evolving information, ensuring that the final output is both accurate and comprehensive. To validate the effectiveness of our framework, we conducted extensive experiments across a range of generative and reasoning tasks. These experiments demonstrated that our framework outperforms conventional inference processes on accuracy, coherence, and diversity. The framework's ability to iteratively expand its search space while retaining contextually relevant information results.

Chain-of-Thought (CoT) prompting empowers the reasoning abilities of Large Language Models (LLMs), eliciting them to solve complex reasoning tasks step-by-step. However, with the success of CoT methods, the ability to deliver multi-step reasoning remains limited to English due to the imbalance in the distribution of the pre-training data, making the other languages a barrier. In this work, we propose a Cross-lingual multi-step reasoning approach, aiming to align reasoning processes across different languages. In particular, our method, through a Self-consistent Cross-lingual prompting mechanism inspired by the Tree-of-Thoughts approach, delivers multi-step reasoning paths in different languages that, during the steps, lead to the final solution. Our experimental evaluations show that our method significantly outperforms existing prompting methods, reducing the number of interactions and achieving state-of-the-art performance.

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

Generating synthetic text addresses the challenge of data availability in privacy-sensitive domains such as healthcare. This study explores the applicability of synthetic data in real-world medical settings. We introduce MedSyn, a novel medical text generation framework that integrates large language models with a Medical Knowledge Graph (MKG). We use MKG to sample prior medical information for the prompt and generate synthetic clinical notes with GPT-4 and fine-tuned LLaMA models. We assess the benefit of synthetic data through application in the ICD code prediction task. Our research indicates that synthetic data can increase the classification accuracy of vital and challenging codes by up to 17.8% compared to settings without synthetic data. Furthermore, to provide new data for further research in the healthcare domain, we present the largest open-source synthetic dataset of clinical notes for the Russian language, comprising over 41k samples covering 219 ICD-10 codes.

Recent advancements in large language models (LLMs) have demonstrated their impressive abilities in various reasoning and decision-making tasks. However, the quality and coherence of the reasoning process can still benefit from enhanced introspection and self-reflection. In this paper, we introduce Multiplex CoT (Chain of Thought), a method that enables LLMs to simulate a form of self-review while reasoning, by initiating double Chain of Thought (CoT) thinking. Multiplex CoT leverages the power of iterative reasoning, where the model generates an initial chain of thought and subsequently critiques and refines this reasoning with a second round of thought generation. This recursive approach allows for more coherent, logical, and robust answers, improving the overall decision-making process. We demonstrate how this method can be effectively implemented using simple prompt engineering in existing LLM architectures, achieving an effect similar to that of the Learning-Refinement Model (LRM) without the need for additional training. Additionally, we present a practical guide for implementing the method in Google Colab, enabling easy integration into real-world applications.

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Large language models (LLMs) have performed well in providing general and extensive health suggestions in single-turn conversations, exemplified by systems such as ChatGPT, ChatGLM, ChatDoctor, DoctorGLM, and etc. However, the limited information provided by users during single turn results in inadequate personalization and targeting of the generated suggestions, which requires users to independently select the useful part. It is mainly caused by the missing ability to engage in multi-turn questioning. In real-world medical consultations, doctors usually employ a series of iterative inquiries to comprehend the patient's condition thoroughly, enabling them to provide effective and personalized suggestions subsequently, which can be defined as chain of questioning (CoQ) for LLMs. To improve the CoQ of LLMs, we propose BianQue, a ChatGLM-based LLM finetuned with the self-constructed health conversation dataset BianQueCorpus that is consist of multiple turns of questioning and health suggestions polished by ChatGPT. Experimental results demonstrate that the proposed BianQue can simultaneously balance the capabilities of both questioning and health suggestions, which will help promote the research and application of LLMs in the field of proactive health.

Although large language models (LLMs) often produce impressive outputs, it remains unclear how they perform in real-world scenarios requiring strong reasoning skills and expert domain knowledge. We set out to investigate whether close- and open-source models (GPT-3.5, LLama-2, etc.) can be applied to answer and reason about difficult real-world-based questions. We focus on three popular medical benchmarks (MedQA-USMLE, MedMCQA, and PubMedQA) and multiple prompting scenarios: Chain-of-Thought (CoT, think step-by-step), few-shot and retrieval augmentation. Based on an expert annotation of the generated CoTs, we found that InstructGPT can often read, reason and recall expert knowledge. Last, by leveraging advances in prompt engineering (few-shot and ensemble methods), we demonstrated that GPT-3.5 not only yields calibrated predictive distributions, but also reaches the passing score on three datasets: MedQA-USMLE 60.2%, MedMCQA 62.7% and PubMedQA 78.2%. Open-source models are closing the gap: Llama-2 70B also passed the MedQA-USMLE with 62.5% accuracy.

Large language models (LLMs) have exhibited remarkable capabilities across various domains and tasks, pushing the boundaries of our knowledge in learning and cognition. The latest model, OpenAI's o1, stands out as the first LLM with an internalized chain-of-thought technique using reinforcement learning strategies. While it has demonstrated surprisingly strong capabilities on various general language tasks, its performance in specialized fields such as medicine remains unknown. To this end, this report provides a comprehensive exploration of o1 on different medical scenarios, examining 3 key aspects: understanding, reasoning, and multilinguality. Specifically, our evaluation encompasses 6 tasks using data from 37 medical datasets, including two newly constructed and more challenging question-answering (QA) tasks based on professional medical quizzes from the New England Journal of Medicine (NEJM) and The Lancet. These datasets offer greater clinical relevance compared to standard medical QA benchmarks such as MedQA, translating more effectively into real-world clinical utility. Our analysis of o1 suggests that the enhanced reasoning ability of LLMs may (significantly) benefit their capability to understand various medical instructions and reason through complex clinical scenarios. Notably, o1 surpasses the previous GPT-4 in accuracy by an average of 6.2% and 6.6% across 19 datasets and two newly created complex QA scenarios. But meanwhile, we identify several weaknesses in both the model capability and the existing evaluation protocols, including hallucination, inconsistent multilingual ability, and discrepant metrics for evaluation. We release our raw data and model outputs at https://ucsc-vlaa.github.io/o1_medicine/ for future research.

Large language models (LLMs) now achieve near-human performance on standard math word problem benchmarks (e.g., GSM8K), yet their true reasoning ability remains disputed. A key concern is that models often produce confident, yet unfounded, answers to unanswerable problems. We introduce TreeCut, a synthetic dataset that systematically generates infinite unanswerable math word problems and their answerable counterparts, by representing each question as a tree and removing chosen necessary conditions. Experiments show TreeCut effectively induce hallucinations in large language models, including GPT-4o and o3-mini, with rates of 64% and 44% in their respective worst-case scenarios under zero-shot setting. Further analysis highlights that deeper or more complex trees, composite item names, and removing necessary condition near the middle of a path all increase the likelihood of hallucinations, underscoring the persistent challenges LLMs face in identifying unanswerable math problems. The dataset generation code and sample data are available at https://github.com/j-bagel/treecut-math.

We present THOUGHTSCULPT, a general reasoning and search method for tasks with outputs that can be decomposed into components. THOUGHTSCULPT explores a search tree of potential solutions using Monte Carlo Tree Search (MCTS), building solutions one action at a time and evaluating according to any domain-specific heuristic, which in practice is often simply an LLM evaluator. Critically, our action space includes revision actions: THOUGHTSCULPT may choose to revise part of its previous output rather than continuing to build the rest of its output. Empirically, THOUGHTSCULPT outperforms state-of-the-art reasoning methods across three challenging tasks: Story Outline Improvement (up to +30% interestingness), Mini-Crosswords Solving (up to +16% word success rate), and Constrained Generation (up to +10% concept coverage).

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

Large language models (LLMs) have demonstrated remarkable capabilities in tasks requiring reasoning and multi-step problem-solving through the use of chain-of-thought (CoT) prompting. However, generating the full CoT process results in significantly longer output sequences, leading to increased computational costs and latency during inference. To address this challenge, we propose a novel approach to compress the CoT process through semantic alignment, enabling more efficient decoding while preserving the benefits of CoT reasoning. Our method introduces an auxiliary CoT model that learns to generate and compress the full thought process into a compact special token representation semantically aligned with the original CoT output. This compressed representation is then integrated into the input of the Hidden Chain-of-Thought (HCoT) model. The training process follows a two-stage procedure: First, the CoT model is optimized to generate the compressed token representations aligned with the ground-truth CoT outputs using a contrastive loss. Subsequently, with the CoT model parameters frozen, the HCoT model is fine-tuned to generate accurate subsequent predictions conditioned on the prefix instruction and the compressed CoT representations from the CoT model. Extensive experiments across three challenging domains - mathematical reasoning, agent invocation, and question answering - demonstrate that our semantic compression approach achieves competitive or improved performance compared to the full CoT baseline, while providing significant speedups of at least 1.5x in decoding time. Moreover, incorporating contrastive learning objectives further enhances the quality of the compressed representations, leading to better CoT prompting and improved task accuracy. Our work paves the way for more efficient exploitation of multi-step reasoning capabilities in LLMs across a wide range of applications.

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

Electronic health records (EHR) contain narrative notes that provide extensive details on the medical condition and management of patients. Natural language processing (NLP) of clinical notes can use observed frequencies of clinical terms as predictive features for downstream applications such as clinical decision making and patient trajectory prediction. However, due to the vast number of highly similar and related clinical concepts, a more effective modeling strategy is to represent clinical terms as semantic embeddings via representation learning and use the low dimensional embeddings as feature vectors for predictive modeling. To achieve efficient representation, fine-tuning pretrained language models with biomedical knowledge graphs may generate better embeddings for biomedical terms than those from standard language models alone. These embeddings can effectively discriminate synonymous pairs of from those that are unrelated. However, they often fail to capture different degrees of similarity or relatedness for concepts that are hierarchical in nature. To overcome this limitation, we propose HiPrBERT, a novel biomedical term representation model trained on additionally complied data that contains hierarchical structures for various biomedical terms. We modify an existing contrastive loss function to extract information from these hierarchies. Our numerical experiments demonstrate that HiPrBERT effectively learns the pair-wise distance from hierarchical information, resulting in a substantially more informative embeddings for further biomedical applications

Large Language Models (LLMs) have shown remarkable abilities across various language tasks, but solving complex reasoning problems remains a challenge. While existing methods like Chain-of-Thought (CoT) and Tree-of-Thought (ToT) enhance reasoning by decomposing problems or structuring prompts, they typically perform a single pass of reasoning and may fail to revisit flawed paths, compromising accuracy. To address this, we propose a novel reasoning framework called Forest-of-Thought (FoT), which integrates multiple reasoning trees to leverage collective decision-making for solving complex logical problems. FoT utilizes sparse activation strategies to select the most relevant reasoning paths, improving both efficiency and accuracy. Additionally, we introduce a dynamic self-correction strategy that enables real-time error correction and learning from past mistakes, as well as consensus-guided decision making strategies to optimize correctness and computational resources. Experimental results demonstrate that the FoT framework, combined with these strategies, significantly enhances the reasoning capabilities of LLMs, enabling them to solve complex tasks with greater precision and efficiency.

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

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

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

The integration of Large Language Models (LLMs) into healthcare holds significant potential to enhance diagnostic accuracy and support medical treatment planning. These AI-driven systems can analyze vast datasets, assisting clinicians in identifying diseases, recommending treatments, and predicting patient outcomes. This study evaluates the performance of a range of contemporary LLMs, including both open-source and closed-source models, on the 2024 Portuguese National Exam for medical specialty access (PNA), a standardized medical knowledge assessment. Our results highlight considerable variation in accuracy and cost-effectiveness, with several models demonstrating performance exceeding human benchmarks for medical students on this specific task. We identify leading models based on a combined score of accuracy and cost, discuss the implications of reasoning methodologies like Chain-of-Thought, and underscore the potential for LLMs to function as valuable complementary tools aiding medical professionals in complex clinical decision-making.

We present Thinking with Generated Images, a novel paradigm that fundamentally transforms how large multimodal models (LMMs) engage with visual reasoning by enabling them to natively think across text and vision modalities through spontaneous generation of intermediate visual thinking steps. Current visual reasoning with LMMs is constrained to either processing fixed user-provided images or reasoning solely through text-based chain-of-thought (CoT). Thinking with Generated Images unlocks a new dimension of cognitive capability where models can actively construct intermediate visual thoughts, critique their own visual hypotheses, and refine them as integral components of their reasoning process. We demonstrate the effectiveness of our approach through two complementary mechanisms: (1) vision generation with intermediate visual subgoals, where models decompose complex visual tasks into manageable components that are generated and integrated progressively, and (2) vision generation with self-critique, where models generate an initial visual hypothesis, analyze its shortcomings through textual reasoning, and produce refined outputs based on their own critiques. Our experiments on vision generation benchmarks show substantial improvements over baseline approaches, with our models achieving up to 50% (from 38% to 57%) relative improvement in handling complex multi-object scenarios. From biochemists exploring novel protein structures, and architects iterating on spatial designs, to forensic analysts reconstructing crime scenes, and basketball players envisioning strategic plays, our approach enables AI models to engage in the kind of visual imagination and iterative refinement that characterizes human creative, analytical, and strategic thinking. We release our open-source suite at https://github.com/GAIR-NLP/thinking-with-generated-images.

Image classification, a pivotal task in multiple industries, faces computational challenges due to the burgeoning volume of visual data. This research addresses these challenges by introducing two quantum machine learning models that leverage the principles of quantum mechanics for effective computations. Our first model, a hybrid quantum neural network with parallel quantum circuits, enables the execution of computations even in the noisy intermediate-scale quantum era, where circuits with a large number of qubits are currently infeasible. This model demonstrated a record-breaking classification accuracy of 99.21% on the full MNIST dataset, surpassing the performance of known quantum-classical models, while having eight times fewer parameters than its classical counterpart. Also, the results of testing this hybrid model on a Medical MNIST (classification accuracy over 99%), and on CIFAR-10 (classification accuracy over 82%), can serve as evidence of the generalizability of the model and highlights the efficiency of quantum layers in distinguishing common features of input data. Our second model introduces a hybrid quantum neural network with a Quanvolutional layer, reducing image resolution via a convolution process. The model matches the performance of its classical counterpart, having four times fewer trainable parameters, and outperforms a classical model with equal weight parameters. These models represent advancements in quantum machine learning research and illuminate the path towards more accurate image classification systems.

We introduce Diagram of Thought (DoT), a framework that models iterative reasoning in large language models (LLMs) as the construction of a directed acyclic graph (DAG) within a single model. Unlike traditional approaches that represent reasoning as linear chains or trees, DoT organizes propositions, critiques, refinements, and verifications into a cohesive DAG structure, allowing the model to explore complex reasoning pathways while maintaining logical consistency. Each node in the diagram corresponds to a proposition that has been proposed, critiqued, refined, or verified, enabling the LLM to iteratively improve its reasoning through natural language feedback. By leveraging auto-regressive next-token prediction with role-specific tokens, DoT facilitates seamless transitions between proposing ideas and critically evaluating them, providing richer feedback than binary signals. Furthermore, we formalize the DoT framework using Topos Theory, providing a mathematical foundation that ensures logical consistency and soundness in the reasoning process. This approach enhances both the training and inference processes within a single LLM, eliminating the need for multiple models or external control mechanisms. DoT offers a conceptual framework for designing next-generation reasoning-specialized models, emphasizing training efficiency, robust reasoning capabilities, and theoretical grounding. The code is available at https://github.com/diagram-of-thought/diagram-of-thought.

Chain-of-Thought (CoT) prompting has proven highly effective for enhancing complex reasoning in Large Language Models (LLMs) and Multimodal Large Language Models (MLLMs). Yet, it struggles in complex spatial reasoning tasks. Nonetheless, human cognition extends beyond language alone, enabling the remarkable capability to think in both words and images. Inspired by this mechanism, we propose a new reasoning paradigm, Multimodal Visualization-of-Thought (MVoT). It enables visual thinking in MLLMs by generating image visualizations of their reasoning traces. To ensure high-quality visualization, we introduce token discrepancy loss into autoregressive MLLMs. This innovation significantly improves both visual coherence and fidelity. We validate this approach through several dynamic spatial reasoning tasks. Experimental results reveal that MVoT demonstrates competitive performance across tasks. Moreover, it exhibits robust and reliable improvements in the most challenging scenarios where CoT fails. Ultimately, MVoT establishes new possibilities for complex reasoning tasks where visual thinking can effectively complement verbal reasoning.

Test-time scaling has emerged as a powerful technique for enhancing the reasoning capabilities of large language models. However, its effectiveness in medical reasoning remains uncertain, as the medical domain fundamentally differs from mathematical tasks in terms of knowledge representation and decision-making processes. In this paper, we provide the first comprehensive investigation of test-time scaling for medical reasoning and present m1, a simple yet effective approach that increases a model's medical reasoning capability at inference. Our evaluation across diverse medical tasks demonstrates that test-time scaling consistently enhances medical reasoning, enabling lightweight fine-tuned models under 10B parameters to establish new state-of-the-art performance, while our 32B model rivals previous 70B-scale medical LLMs. However, we identify an optimal reasoning token budget of approximately 4K, beyond which performance may degrade due to overthinking. Budget forcing, which extends test-time computation through iterative prompts, helps models double-check answers but does not necessarily improve the overall medical QA performance and, in some cases, even introduces errors into previously correct responses. Our case-by-case analysis identifies insufficient medical knowledge as a key bottleneck that prevents further performance gains through test-time scaling. We find that increasing data scale, improving data quality, and expanding model capacity consistently enhance medical knowledge grounding, enabling continued performance improvements, particularly on challenging medical benchmarks where smaller models reach saturation. These findings underscore fundamental differences between medical and mathematical reasoning in LLMs, highlighting that enriched medical knowledge, other than increased reasoning depth alone, is essential for realizing the benefits of test-time scaling.

Large Language Models, such as Generative Pre-trained Transformer 3 (aka. GPT-3), have been developed to understand language through the analysis of extensive text data, allowing them to identify patterns and connections between words. While LLMs have demonstrated impressive performance across various text-related tasks, they encounter challenges in tasks associated with reasoning. To address this challenge, Chain of Thought(CoT) prompting method has been proposed as a means to enhance LLMs' proficiency in complex reasoning tasks like solving math word problems and answering questions based on logical argumentative reasoning. The primary aim of this research is to assess how well four language models can grade reflective essays of third-year medical students. The assessment will specifically target the evaluation of critical thinking skills using CoT prompting. The research will provide the following contributions; to introduce and educate on the process of instructing models to evaluate reflective essays from a dataset they have not been previously trained on; to illustrate the use of CoT prompting as an instructional approach for training large models to carry out particular tasks. Our results suggest that among all the models, Llama-7b performs the least effectively, displaying the highest mean squared error. Conversely, ChatGPT emerges as the superior model, boasting a higher Cohen kappa score value of 0.53. Lastly, it's important to note that the selected models do prioritise user privacy by allowing users to delete their own conducted conversations.

Chain-of-thought reasoning, a cognitive process fundamental to human intelligence, has garnered significant attention in the realm of artificial intelligence and natural language processing. However, there still remains a lack of a comprehensive survey for this arena. To this end, we take the first step and present a thorough survey of this research field carefully and widely. We use X-of-Thought to refer to Chain-of-Thought in a broad sense. In detail, we systematically organize the current research according to the taxonomies of methods, including XoT construction, XoT structure variants, and enhanced XoT. Additionally, we describe XoT with frontier applications, covering planning, tool use, and distillation. Furthermore, we address challenges and discuss some future directions, including faithfulness, multi-modal, and theory. We hope this survey serves as a valuable resource for researchers seeking to innovate within the domain of chain-of-thought reasoning.

Though reasoning-based large language models (LLMs) have excelled in mathematics and programming, their capabilities in knowledge-intensive medical question answering remain underexplored. To address this, we introduce ReasonMed, the largest medical reasoning dataset, comprising 370k high-quality examples distilled from 1.7 million initial reasoning paths generated by various LLMs. ReasonMed is constructed through a multi-agent verification and refinement process, where we design an Error Refiner to enhance the reasoning paths by identifying and correcting error-prone steps flagged by a verifier. Leveraging ReasonMed, we systematically investigate best practices for training medical reasoning models and find that combining detailed Chain-of-Thought (CoT) reasoning with concise answer summaries yields the most effective fine-tuning strategy. Based on this strategy, we train ReasonMed-7B, which sets a new benchmark for sub-10B models, outperforming the prior best by 4.17\% and even exceeding LLaMA3.1-70B on PubMedQA by 4.60\%.

This work introduces BioLORD, a new pre-training strategy for producing meaningful representations for clinical sentences and biomedical concepts. State-of-the-art methodologies operate by maximizing the similarity in representation of names referring to the same concept, and preventing collapse through contrastive learning. However, because biomedical names are not always self-explanatory, it sometimes results in non-semantic representations. BioLORD overcomes this issue by grounding its concept representations using definitions, as well as short descriptions derived from a multi-relational knowledge graph consisting of biomedical ontologies. Thanks to this grounding, our model produces more semantic concept representations that match more closely the hierarchical structure of ontologies. BioLORD establishes a new state of the art for text similarity on both clinical sentences (MedSTS) and biomedical concepts (MayoSRS).

The ability to interpret and intervene model decisions is important for the adoption of computer-aided diagnosis methods in clinical workflows. Recent concept-based methods link the model predictions with interpretable concepts and modify their activation scores to interact with the model. However, these concepts are at the image level, which hinders the model from pinpointing the exact patches the concepts are activated. Alternatively, prototype-based methods learn representations from training image patches and compare these with test image patches, using the similarity scores for final class prediction. However, interpreting the underlying concepts of these patches can be challenging and often necessitates post-hoc guesswork. To address this issue, this paper introduces the novel Concept-based Similarity Reasoning network (CSR), which offers (i) patch-level prototype with intrinsic concept interpretation, and (ii) spatial interactivity. First, the proposed CSR provides localized explanation by grounding prototypes of each concept on image regions. Second, our model introduces novel spatial-level interaction, allowing doctors to engage directly with specific image areas, making it an intuitive and transparent tool for medical imaging. CSR improves upon prior state-of-the-art interpretable methods by up to 4.5\% across three biomedical datasets. Our code is released at https://github.com/tadeephuy/InteractCSR.

LLMs are bound to transform healthcare with advanced decision support and flexible chat assistants. However, LLMs are prone to generate inaccurate medical content. To ground LLMs in high-quality medical knowledge, LLMs have been equipped with external knowledge via RAG, where unstructured medical knowledge is split into small text chunks that can be selectively retrieved and integrated into the LLMs context. Yet, existing RAG pipelines rely on raw, unstructured medical text, which can be noisy, uncurated and difficult for LLMs to effectively leverage. Systematic approaches to organize medical knowledge to best surface it to LLMs are generally lacking. To address these challenges, we introduce MIRIAD, a large-scale, curated corpus of 5,821,948 medical QA pairs, each rephrased from and grounded in a passage from peer-reviewed medical literature using a semi-automated pipeline combining LLM generation, filtering, grounding, and human annotation. Unlike prior medical corpora, which rely on unstructured text, MIRIAD encapsulates web-scale medical knowledge in an operationalized query-response format, which enables more targeted retrieval. Experiments on challenging medical QA benchmarks show that augmenting LLMs with MIRIAD improves accuracy up to 6.7% compared to unstructured RAG baselines with the same source corpus and with the same amount of retrieved text. Moreover, MIRIAD improved the ability of LLMs to detect medical hallucinations by 22.5 to 37% (increase in F1 score). We further introduce MIRIAD-Atlas, an interactive map of MIRIAD spanning 56 medical disciplines, enabling clinical users to visually explore, search, and refine medical knowledge. MIRIAD promises to unlock a wealth of down-stream applications, including medical information retrievers, enhanced RAG applications, and knowledge-grounded chat interfaces, which ultimately enables more reliable LLM applications in healthcare.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

In this study, we aim to build up a model that can Segment Anything in radiology scans, driven by medical terminologies as Text prompts, termed as SAT. Our main contributions are three folds: (i) for dataset construction, we construct the first multi-modal knowledge tree on human anatomy, including 6502 anatomical terminologies; Then, we build up the largest and most comprehensive segmentation dataset for training, by collecting over 22K 3D medical image scans from72 segmentation datasets, across 497 classes, with careful standardization on both image scans and label space; (ii) for architecture design, we propose to inject medical knowledge into a text encoder via contrastive learning, and then formulate a universal segmentation model, that can be prompted by feeding in medical terminologies in text form; (iii) As a result, we have trained SAT-Nano (110M parameters) and SAT-Pro (447M parameters), demonstrating superior or comparable performance to 72 specialist models, i.e., nnU-Nets, U-Mamba or SwinUNETR, trained on each dataset/subsets. We validate SAT as a foundational segmentation model, with better generalization on external (cross-center) datasets, and can be further improved on specific tasks after fine-tuning adaptation. Comparing with state-of-the-art interactive segmentation model MedSAM, SAT demonstrate superior performance, scalability and robustness. We further compare SAT with BiomedParse, and observe SAT is significantly superior in both internal and external evaluation. Through extensive ablation study, we validate the benefit of domain knowledge on universal segmentation, especially on tail categories. As a use case, we demonstrate that SAT can act as a powerful out-of-the-box agent for large language models, enabling visual grounding in versatile application scenarios. All the data, codes, and models in this work have been released.

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

Multimodal large language models (MLLMs) have advanced the integration of visual and linguistic modalities, establishing themselves as the dominant paradigm for visual-language tasks. Current approaches like chain of thought (CoT) reasoning have augmented the cognitive capabilities of large language models (LLMs), yet their adaptation to MLLMs is hindered by heightened risks of hallucination in cross-modality comprehension. In this paper, we find that the thinking while looking paradigm in current multimodal CoT approaches--where reasoning chains are generated alongside visual input--fails to mitigate hallucinations caused by misleading images. To address these limitations, we propose the Visual Inference Chain (VIC) framework, a novel approach that constructs reasoning chains using textual context alone before introducing visual input, effectively reducing cross-modal biases and enhancing multimodal reasoning accuracy. Comprehensive evaluations demonstrate that VIC significantly improves zero-shot performance across various vision-related tasks, mitigating hallucinations while refining the reasoning capabilities of MLLMs. Our code repository can be found at https://github.com/Terry-Xu-666/visual_inference_chain.

Large Language Models (LLMs) have shown impressive performance on existing medical question-answering benchmarks. This high performance makes it increasingly difficult to meaningfully evaluate and differentiate advanced methods. We present MedAgentsBench, a benchmark that focuses on challenging medical questions requiring multi-step clinical reasoning, diagnosis formulation, and treatment planning-scenarios where current models still struggle despite their strong performance on standard tests. Drawing from seven established medical datasets, our benchmark addresses three key limitations in existing evaluations: (1) the prevalence of straightforward questions where even base models achieve high performance, (2) inconsistent sampling and evaluation protocols across studies, and (3) lack of systematic analysis of the interplay between performance, cost, and inference time. Through experiments with various base models and reasoning methods, we demonstrate that the latest thinking models, DeepSeek R1 and OpenAI o3, exhibit exceptional performance in complex medical reasoning tasks. Additionally, advanced search-based agent methods offer promising performance-to-cost ratios compared to traditional approaches. Our analysis reveals substantial performance gaps between model families on complex questions and identifies optimal model selections for different computational constraints. Our benchmark and evaluation framework are publicly available at https://github.com/gersteinlab/medagents-benchmark.

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

Large Vision-Language Models (LVLMs) have recently demonstrated amazing success in multi-modal tasks, including advancements in Multi-modal Chain-of-Thought (MCoT) reasoning. Despite these successes, current benchmarks still follow a traditional paradigm with multi-modal input and text-modal output, which leads to significant drawbacks such as missing visual operations and vague expressions. Motivated by this, we introduce a novel Chain of Multi-modal Thought (CoMT) benchmark to address these limitations. Different from the traditional MCoT benchmark, CoMT requires both multi-modal input and multi-modal reasoning output, aiming to mimic human-like reasoning that inherently integrates visual operation. Specifically, CoMT consists of four categories: (1) Visual Creation, (2) Visual Deletion, (3) Visual Update, and (4) Visual Selection to comprehensively explore complex visual operations and concise expression in real scenarios. We evaluate various LVLMs and strategies on CoMT, revealing some key insights into the capabilities and limitations of the current approaches. We hope that CoMT can inspire more research on introducing multi-modal generation into the reasoning process.

As opposed to evaluating computation and logic-based reasoning, current benchmarks for evaluating large language models (LLMs) in medicine are primarily focused on question-answering involving domain knowledge and descriptive reasoning. While such qualitative capabilities are vital to medical diagnosis, in real-world scenarios, doctors frequently use clinical calculators that follow quantitative equations and rule-based reasoning paradigms for evidence-based decision support. To this end, we propose MedCalc-Bench, a first-of-its-kind dataset focused on evaluating the medical calculation capability of LLMs. MedCalc-Bench contains an evaluation set of over 1000 manually reviewed instances from 55 different medical calculation tasks. Each instance in MedCalc-Bench consists of a patient note, a question requesting to compute a specific medical value, a ground truth answer, and a step-by-step explanation showing how the answer is obtained. While our evaluation results show the potential of LLMs in this area, none of them are effective enough for clinical settings. Common issues include extracting the incorrect entities, not using the correct equation or rules for a calculation task, or incorrectly performing the arithmetic for the computation. We hope our study highlights the quantitative knowledge and reasoning gaps in LLMs within medical settings, encouraging future improvements of LLMs for various clinical calculation tasks.

We introduce MedXpertQA, a highly challenging and comprehensive benchmark to evaluate expert-level medical knowledge and advanced reasoning. MedXpertQA includes 4,460 questions spanning 17 specialties and 11 body systems. It includes two subsets, Text for text evaluation and MM for multimodal evaluation. Notably, MM introduces expert-level exam questions with diverse images and rich clinical information, including patient records and examination results, setting it apart from traditional medical multimodal benchmarks with simple QA pairs generated from image captions. MedXpertQA applies rigorous filtering and augmentation to address the insufficient difficulty of existing benchmarks like MedQA, and incorporates specialty board questions to improve clinical relevance and comprehensiveness. We perform data synthesis to mitigate data leakage risk and conduct multiple rounds of expert reviews to ensure accuracy and reliability. We evaluate 16 leading models on MedXpertQA. Moreover, medicine is deeply connected to real-world decision-making, providing a rich and representative setting for assessing reasoning abilities beyond mathematics and code. To this end, we develop a reasoning-oriented subset to facilitate the assessment of o1-like models.

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

Large Language Models (LLMs) have demonstrated impressive performance in natural language processing tasks by leveraging chain of thought (CoT) that enables step-by-step thinking. Extending LLMs with multimodal capabilities is the recent interest, but incurs computational cost and requires substantial hardware resources. To address these challenges, we propose KAM-CoT a framework that integrates CoT reasoning, Knowledge Graphs (KGs), and multiple modalities for a comprehensive understanding of multimodal tasks. KAM-CoT adopts a two-stage training process with KG grounding to generate effective rationales and answers. By incorporating external knowledge from KGs during reasoning, the model gains a deeper contextual understanding reducing hallucinations and enhancing the quality of answers. This knowledge-augmented CoT reasoning empowers the model to handle questions requiring external context, providing more informed answers. Experimental findings show KAM-CoT outperforms the state-of-the-art methods. On the ScienceQA dataset, we achieve an average accuracy of 93.87%, surpassing GPT-3.5 (75.17%) by 18% and GPT-4 (83.99%) by 10%. Remarkably, KAM-CoT achieves these results with only 280M trainable parameters at a time, demonstrating its cost-efficiency and effectiveness.

Medical Visual Question Answering (MedVQA), which offers language responses to image-based medical inquiries, represents a challenging task and significant advancement in healthcare. It assists medical experts to swiftly interpret medical images, thereby enabling faster and more accurate diagnoses. However, the model interpretability and transparency of existing MedVQA solutions are often limited, posing challenges in understanding their decision-making processes. To address this issue, we devise a semi-automated annotation process to streamline data preparation and build new benchmark MedVQA datasets R-RAD, R-SLAKE and R-Path. These datasets provide intermediate medical decision-making rationales generated by multimodal large language models and human annotations for question-answering pairs in existing MedVQA datasets, i.e., VQA-RAD, SLAKE and PathVQA. Moreover, we design a novel framework, MedThink, which finetunes lightweight pretrained generative models by incorporating medical decision-making rationales. MedThink includes three distinct strategies to generate decision outcomes and corresponding rationales, thereby clearly showcasing the medical decision-making process during reasoning. Our comprehensive experiments show that our method achieves an accuracy of 83.5% on R-RAD, 86.3% on R-SLAKE and 87.2% on R-Path. These results significantly exceed those of existing state-of-the-art models with comparable parameters. Datasets and code will be released.

The use of deep neural models for diagnosis prediction from clinical text has shown promising results. However, in clinical practice such models must not only be accurate, but provide doctors with interpretable and helpful results. We introduce ProtoPatient, a novel method based on prototypical networks and label-wise attention with both of these abilities. ProtoPatient makes predictions based on parts of the text that are similar to prototypical patients - providing justifications that doctors understand. We evaluate the model on two publicly available clinical datasets and show that it outperforms existing baselines. Quantitative and qualitative evaluations with medical doctors further demonstrate that the model provides valuable explanations for clinical decision support.

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

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

Large Language Models (LLMs) present immense potential in the medical field, yet concerns over data privacy, regulatory compliance, and model stability restrict their widespread adoption. Although the distillation of high-performing closed-source LLMs has proven effective for general tasks, their application in healthcare is limited due to reduced domain knowledge and remnants of alignment behavior hindering clinical tasks. To address these challenges, we propose Dialogue-Based Knowledge Encoding (DBKE). DBKE enhances models' implicit knowledge base and primes them for conversational recall, augmenting their conversational capabilities and enabling a soft alignment for subsequent use cases. By transforming dense academic source text into synthetic dialogue, DBKE broadens the model's knowledge base and enables a soft alignment that guides downstream behaviours. We present Clinical Camel, an open-source, healthcare-focused conversational model, to showcase the effectiveness of DBKE. Clinical Camel outperforms GPT-3.5 on the United States Medical Licensing Examination (USMLE) Step 1 and Step 3 with scores of 53.2 % and 58.2 %, respectively, compared to GPT-3.5's scores of 36.1 % and 55.7 %. Clinical Camel adeptly handles multi-stage clinical case problems, provides adaptive counseling, and generates clinical notes. However, it is prone to hallucinations, which pose a significant obstacle in safety-critical settings. The performance of Clinical Camel underscores the importance of continued research and development of open-source models for the safe and effective integration of LLMs in healthcare settings.

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

Recently, there has been significant progress in teaching language models to perform step-by-step reasoning to solve complex numerical reasoning tasks. Chain-of-thoughts prompting (CoT) is by far the state-of-art method for these tasks. CoT uses language models to perform both reasoning and computation in the multi-step `thought' process. To disentangle computation from reasoning, we propose `Program of Thoughts' (PoT), which uses language models (mainly Codex) to express the reasoning process as a program. The computation is relegated to an external computer, which executes the generated programs to derive the answer. We evaluate PoT on five math word problem datasets (GSM, AQuA, SVAMP, TabMWP, MultiArith) and three financial-QA datasets (FinQA, ConvFinQA, TATQA) for both few-shot and zero-shot setups. Under both few-shot and zero-shot settings, PoT can show an average performance gain over CoT by around 12\% across all the evaluated datasets. By combining PoT with self-consistency decoding, we can achieve SoTA performance on all math problem datasets and near-SoTA performance on financial datasets. All of our data and code are released in Github\url{https://github.com/wenhuchen/Program-of-Thoughts}.

As soon as abstract mathematical computations were adapted to computation on digital computers, the problem of efficient representation, manipulation, and communication of the numerical values in those computations arose. Strongly related to the problem of numerical representation is the problem of quantization: in what manner should a set of continuous real-valued numbers be distributed over a fixed discrete set of numbers to minimize the number of bits required and also to maximize the accuracy of the attendant computations? This perennial problem of quantization is particularly relevant whenever memory and/or computational resources are severely restricted, and it has come to the forefront in recent years due to the remarkable performance of Neural Network models in computer vision, natural language processing, and related areas. Moving from floating-point representations to low-precision fixed integer values represented in four bits or less holds the potential to reduce the memory footprint and latency by a factor of 16x; and, in fact, reductions of 4x to 8x are often realized in practice in these applications. Thus, it is not surprising that quantization has emerged recently as an important and very active sub-area of research in the efficient implementation of computations associated with Neural Networks. In this article, we survey approaches to the problem of quantizing the numerical values in deep Neural Network computations, covering the advantages/disadvantages of current methods. With this survey and its organization, we hope to have presented a useful snapshot of the current research in quantization for Neural Networks and to have given an intelligent organization to ease the evaluation of future research in this area.

Recent advances in general medical AI have made significant strides, but existing models often lack the reasoning capabilities needed for complex medical decision-making. This paper presents GMAI-VL-R1, a multimodal medical reasoning model enhanced by reinforcement learning (RL) to improve its reasoning abilities. Through iterative training, GMAI-VL-R1 optimizes decision-making, significantly boosting diagnostic accuracy and clinical support. We also develop a reasoning data synthesis method, generating step-by-step reasoning data via rejection sampling, which further enhances the model's generalization. Experimental results show that after RL training, GMAI-VL-R1 excels in tasks such as medical image diagnosis and visual question answering. While the model demonstrates basic memorization with supervised fine-tuning, RL is crucial for true generalization. Our work establishes new evaluation benchmarks and paves the way for future advancements in medical reasoning models. Code, data, and model will be released at https://github.com/uni-medical/GMAI-VL-R1{this link}.

Large language models have achieved significant advancements in complex mathematical reasoning benchmarks, such as MATH. However, their substantial computational requirements present challenges for practical deployment. Model quantization has emerged as an effective strategy to reduce memory usage and computational costs by employing lower precision and bit-width representations. In this study, we systematically evaluate the impact of quantization on mathematical reasoning tasks. We introduce a multidimensional evaluation framework that qualitatively assesses specific capability dimensions and conduct quantitative analyses on the step-by-step outputs of various quantization methods. Our results demonstrate that quantization differentially affects numerical computation and reasoning planning abilities, identifying key areas where quantized models experience performance degradation.

Recent advancements in large language models (LLMs) have shown promise in medical applications such as disease diagnosis and treatment planning. However, most existing medical LLMs struggle with the advanced reasoning required for complex clinical scenarios, such as differential diagnosis or personalized treatment suggestions. We proposed FineMedLM-o1, which leverages high-quality synthetic medical data and long-form reasoning data for Supervised Fine-Tuning (SFT) and Direct Preference Optimization (DPO), enabling advanced dialogue and deep reasoning capabilities. Additionally, we introduced Test-Time Training (TTT) in the medical domain for the first time, facilitating domain adaptation and ensuring reliable, accurate reasoning. Experimental results demonstrate that FineMedLM-o1 achieves a 23% average performance improvement over prior models on key medical benchmarks. Furthermore, the introduction of TTT provides an additional 14% performance boost, highlighting its effectiveness in enhancing medical reasoning capabilities. To support this process, we also proposed a novel method for synthesizing medical dialogue. Compared to other open-source datasets, our dataset stands out as superior in both quality and complexity. The project and data will be released on GitHub.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Chain-of-Thought (CoT) has widely enhanced mathematical reasoning in Large Language Models (LLMs), but it still remains challenging for extending it to multimodal domains. Existing works either adopt a similar textual reasoning for image input, or seek to interleave visual signals into mathematical CoT. However, they face three key limitations for math problem-solving: reliance on coarse-grained box-shaped image regions, limited perception of vision encoders on math content, and dependence on external capabilities for visual modification. In this paper, we propose MINT-CoT, introducing Mathematical INterleaved Tokens for Chain-of-Thought visual reasoning. MINT-CoT adaptively interleaves relevant visual tokens into textual reasoning steps via an Interleave Token, which dynamically selects visual regions of any shapes within math figures. To empower this capability, we construct the MINT-CoT dataset, containing 54K mathematical problems aligning each reasoning step with visual regions at the token level, accompanied by a rigorous data generation pipeline. We further present a three-stage MINT-CoT training strategy, progressively combining text-only CoT SFT, interleaved CoT SFT, and interleaved CoT RL, which derives our MINT-CoT-7B model. Extensive experiments demonstrate the effectiveness of our method for effective visual interleaved reasoning in mathematical domains, where MINT-CoT-7B outperforms the baseline model by +34.08% on MathVista, +28.78% on GeoQA, and +23.2% on MMStar, respectively. Our code and data are available at https://github.com/xinyan-cxy/MINT-CoT

Biomedical knowledge graphs (BioMedKGs) are essential infrastructures for biomedical and healthcare big data and artificial intelligence (AI), facilitating natural language processing, model development, and data exchange. For decades, these knowledge graphs have been developed via expert curation; however, this method can no longer keep up with today's AI development, and a transition to algorithmically generated BioMedKGs is necessary. In this work, we introduce the Biomedical Informatics Ontology System (BIOS), the first large-scale publicly available BioMedKG generated completely by machine learning algorithms. BIOS currently contains 4.1 million concepts, 7.4 million terms in two languages, and 7.3 million relation triplets. We present the methodology for developing BIOS, including the curation of raw biomedical terms, computational identification of synonymous terms and aggregation of these terms to create concept nodes, semantic type classification of the concepts, relation identification, and biomedical machine translation. We provide statistics on the current BIOS content and perform preliminary assessments of term quality, synonym grouping, and relation extraction. The results suggest that machine learning-based BioMedKG development is a viable alternative to traditional expert curation.

Knowledge Graphs (KGs) are valuable tools for representing relationships between entities in a structured format. Traditionally, these knowledge bases are queried to extract specific information. However, question-answering (QA) over such KGs poses a challenge due to the intrinsic complexity of natural language compared to the structured format and the size of these graphs. Despite these challenges, the structured nature of KGs can provide a solid foundation for grounding the outputs of Large Language Models (LLMs), offering organizations increased reliability and control. Recent advancements in LLMs have introduced reasoning methods at inference time to improve their performance and maximize their capabilities. In this work, we propose integrating these reasoning strategies with KGs to anchor every step or "thought" of the reasoning chains in KG data. Specifically, we evaluate both agentic and automated search methods across several reasoning strategies, including Chain-of-Thought (CoT), Tree-of-Thought (ToT), and Graph-of-Thought (GoT), using GRBench, a benchmark dataset for graph reasoning with domain-specific graphs. Our experiments demonstrate that this approach consistently outperforms baseline models, highlighting the benefits of grounding LLM reasoning processes in structured KG data.

Large Vision-Language Models (LVLMs) are capable of handling diverse data types such as imaging, text, and physiological signals, and can be applied in various fields. In the medical field, LVLMs have a high potential to offer substantial assistance for diagnosis and treatment. Before that, it is crucial to develop benchmarks to evaluate LVLMs' effectiveness in various medical applications. Current benchmarks are often built upon specific academic literature, mainly focusing on a single domain, and lacking varying perceptual granularities. Thus, they face specific challenges, including limited clinical relevance, incomplete evaluations, and insufficient guidance for interactive LVLMs. To address these limitations, we developed the GMAI-MMBench, the most comprehensive general medical AI benchmark with well-categorized data structure and multi-perceptual granularity to date. It is constructed from 285 datasets across 39 medical image modalities, 18 clinical-related tasks, 18 departments, and 4 perceptual granularities in a Visual Question Answering (VQA) format. Additionally, we implemented a lexical tree structure that allows users to customize evaluation tasks, accommodating various assessment needs and substantially supporting medical AI research and applications. We evaluated 50 LVLMs, and the results show that even the advanced GPT-4o only achieves an accuracy of 52%, indicating significant room for improvement. Moreover, we identified five key insufficiencies in current cutting-edge LVLMs that need to be addressed to advance the development of better medical applications. We believe that GMAI-MMBench will stimulate the community to build the next generation of LVLMs toward GMAI. Project Page: https://uni-medical.github.io/GMAI-MMBench.github.io/

Recently, O1-like models have emerged as representative examples, illustrating the effectiveness of long chain-of-thought (CoT) in reasoning tasks such as math and coding tasks. In this paper, we introduce DRT-o1, an attempt to bring the success of long CoT to neural machine translation (MT). Specifically, in view of the literature books that might involve similes and metaphors, translating these texts to a target language is very difficult in practice due to cultural differences. In such cases, literal translation often fails to convey the intended meaning effectively. Even for professional human translators, considerable thought must be given to preserving semantics throughout the translation process. To simulate LLMs' long thought ability in MT, we first mine sentences containing similes or metaphors from existing literature books, and then develop a multi-agent framework to translate these sentences via long thought. In the multi-agent framework, a translator is used to iteratively translate the source sentence under the suggestions provided by an advisor. To ensure the effectiveness of the long thoughts, an evaluator is also employed to judge whether the translation in the current round is better than the previous one or not. In this manner, we collect tens of thousands of long-thought MT data, which is used to train our DRT-o1. The experimental results on literature translation demonstrate the effectiveness of the DRT-o1. Using Qwen2.5-7B and Qwen2.5-14B as the backbones, the improvement brought by DRT-o1 achieves 7.33~8.26 BLEU and 1.66~3.36 CometScore. Besides, DRT-o1-7B can outperform QwQ-32B-Preview by 7.82 BLEU and 1.46 CometScore, showing its effectiveness. The project is available at https://github.com/krystalan/DRT-o1

Recent advances in large language models have demonstrated remarkable reasoning capabilities through Chain of Thought (CoT) prompting, but often at the cost of excessive verbosity in their intermediate outputs, which increases computational overhead. We introduce Sketch-of-Thought (SoT), a novel prompting framework that combines cognitive-inspired reasoning paradigms with linguistic constraints to minimize token usage while preserving reasoning accuracy. SoT is designed as a flexible framework that can incorporate any custom reasoning paradigms based on cognitive science, and we instantiate it with three such paradigms - Conceptual Chaining, Chunked Symbolism, and Expert Lexicons - each tailored to different reasoning tasks and selected dynamically via a lightweight routing model. Through comprehensive evaluation across 15 reasoning datasets with multiple languages and multimodal scenarios, we demonstrate that SoT achieves token reductions of 76% with negligible accuracy impact. In certain domains like mathematical and multi-hop reasoning, it even improves accuracy while using significantly fewer tokens. Our code is publicly available: https://www.github.com/SimonAytes/SoT.

Clinical decision-making routinely demands reasoning over heterogeneous data, yet existing multimodal language models (MLLMs) remain largely vision-centric and fail to generalize across clinical specialties. To bridge this gap, we introduce QoQ-Med-7B/32B, the first open generalist clinical foundation model that jointly reasons across medical images, time-series signals, and text reports. QoQ-Med is trained with Domain-aware Relative Policy Optimization (DRPO), a novel reinforcement-learning objective that hierarchically scales normalized rewards according to domain rarity and modality difficulty, mitigating performance imbalance caused by skewed clinical data distributions. Trained on 2.61 million instruction tuning pairs spanning 9 clinical domains, we show that DRPO training boosts diagnostic performance by 43% in macro-F1 on average across all visual domains as compared to other critic-free training methods like GRPO. Furthermore, with QoQ-Med trained on intensive segmentation data, it is able to highlight salient regions related to the diagnosis, with an IoU 10x higher than open models while reaching the performance of OpenAI o4-mini. To foster reproducibility and downstream research, we release (i) the full model weights, (ii) the modular training pipeline, and (iii) all intermediate reasoning traces at https://github.com/DDVD233/QoQ_Med.

We explore how iterative revising a chain of thoughts with the help of information retrieval significantly improves large language models' reasoning and generation ability in long-horizon generation tasks, while hugely mitigating hallucination. In particular, the proposed method -- *retrieval-augmented thoughts* (RAT) -- revises each thought step one by one with retrieved information relevant to the task query, the current and the past thought steps, after the initial zero-shot CoT is generated. Applying RAT to GPT-3.5, GPT-4, and CodeLLaMA-7b substantially improves their performances on various long-horizon generation tasks; on average of relatively increasing rating scores by 13.63% on code generation, 16.96% on mathematical reasoning, 19.2% on creative writing, and 42.78% on embodied task planning. The demo page can be found at https://craftjarvis.github.io/RAT

We present QuantumLLMInstruct (QLMMI), an innovative dataset featuring over 500,000 meticulously curated instruction-following problem-solution pairs designed specifically for quantum computing - the largest and most comprehensive dataset of its kind. Originating from over 90 primary seed domains and encompassing hundreds of subdomains autonomously generated by LLMs, QLMMI marks a transformative step in the diversity and richness of quantum computing datasets. Designed for instruction fine-tuning, QLMMI seeks to significantly improve LLM performance in addressing complex quantum computing challenges across a wide range of quantum physics topics. While Large Language Models (LLMs) have propelled advancements in computational science with datasets like Omni-MATH and OpenMathInstruct, these primarily target Olympiad-level mathematics, leaving quantum computing largely unexplored. The creation of QLMMI follows a rigorous four-stage methodology. Initially, foundational problems are developed using predefined templates, focusing on critical areas such as synthetic Hamiltonians, QASM code generation, Jordan-Wigner transformations, and Trotter-Suzuki quantum circuit decompositions. Next, detailed and domain-specific solutions are crafted to ensure accuracy and relevance. In the third stage, the dataset is enriched through advanced reasoning techniques, including Chain-of-Thought (CoT) and Task-Oriented Reasoning and Action (ToRA), which enhance problem-solution diversity while adhering to strict mathematical standards. Lastly, a zero-shot Judge LLM performs self-assessments to validate the dataset's quality and reliability, minimizing human oversight requirements.

Biomedical knowledge is uniquely complex and structured, requiring distinct reasoning strategies compared to other scientific disciplines like physics or chemistry. Biomedical scientists do not rely on a single approach to reasoning; instead, they use various strategies, including rule-based, prototype-based, and case-based reasoning. This diversity calls for flexible approaches that accommodate multiple reasoning strategies while leveraging in-domain knowledge. We introduce KGARevion, a knowledge graph (KG) based agent designed to address the complexity of knowledge-intensive medical queries. Upon receiving a query, KGARevion generates relevant triplets by using the knowledge base of the LLM. These triplets are then verified against a grounded KG to filter out erroneous information and ensure that only accurate, relevant data contribute to the final answer. Unlike RAG-based models, this multi-step process ensures robustness in reasoning while adapting to different models of medical reasoning. Evaluations on four gold-standard medical QA datasets show that KGARevion improves accuracy by over 5.2%, outperforming 15 models in handling complex medical questions. To test its capabilities, we curated three new medical QA datasets with varying levels of semantic complexity, where KGARevion achieved a 10.4% improvement in accuracy.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

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

Neural network quantization aims to accelerate and trim full-precision neural network models by using low bit approximations. Methods adopting the quantization aware training (QAT) paradigm have recently seen a rapid growth, but are often conceptually complicated. This paper proposes a novel and highly effective QAT method, quantized feature distillation (QFD). QFD first trains a quantized (or binarized) representation as the teacher, then quantize the network using knowledge distillation (KD). Quantitative results show that QFD is more flexible and effective (i.e., quantization friendly) than previous quantization methods. QFD surpasses existing methods by a noticeable margin on not only image classification but also object detection, albeit being much simpler. Furthermore, QFD quantizes ViT and Swin-Transformer on MS-COCO detection and segmentation, which verifies its potential in real world deployment. To the best of our knowledge, this is the first time that vision transformers have been quantized in object detection and image segmentation tasks.

Medical Visual Language Models have shown great potential in various healthcare applications, including medical image captioning and diagnostic assistance. However, most existing models rely on text-based instructions, limiting their usability in real-world clinical environments especially in scenarios such as surgery, text-based interaction is often impractical for physicians. In addition, current medical image analysis models typically lack comprehensive reasoning behind their predictions, which reduces their reliability for clinical decision-making. Given that medical diagnosis errors can have life-changing consequences, there is a critical need for interpretable and rational medical assistance. To address these challenges, we introduce an end-to-end speech-driven medical VLM, SilVar-Med, a multimodal medical image assistant that integrates speech interaction with VLMs, pioneering the task of voice-based communication for medical image analysis. In addition, we focus on the interpretation of the reasoning behind each prediction of medical abnormalities with a proposed reasoning dataset. Through extensive experiments, we demonstrate a proof-of-concept study for reasoning-driven medical image interpretation with end-to-end speech interaction. We believe this work will advance the field of medical AI by fostering more transparent, interactive, and clinically viable diagnostic support systems. Our code and dataset are publicly available at SiVar-Med.

When answering a question, humans utilize the information available across different modalities to synthesize a consistent and complete chain of thought (CoT). This process is normally a black box in the case of deep learning models like large-scale language models. Recently, science question benchmarks have been used to diagnose the multi-hop reasoning ability and interpretability of an AI system. However, existing datasets fail to provide annotations for the answers, or are restricted to the textual-only modality, small scales, and limited domain diversity. To this end, we present Science Question Answering (ScienceQA), a new benchmark that consists of ~21k multimodal multiple choice questions with a diverse set of science topics and annotations of their answers with corresponding lectures and explanations. We further design language models to learn to generate lectures and explanations as the chain of thought (CoT) to mimic the multi-hop reasoning process when answering ScienceQA questions. ScienceQA demonstrates the utility of CoT in language models, as CoT improves the question answering performance by 1.20% in few-shot GPT-3 and 3.99% in fine-tuned UnifiedQA. We also explore the upper bound for models to leverage explanations by feeding those in the input; we observe that it improves the few-shot performance of GPT-3 by 18.96%. Our analysis further shows that language models, similar to humans, benefit from explanations to learn from fewer data and achieve the same performance with just 40% of the data. The data and code are available at https://scienceqa.github.io.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Reasoning models have demonstrated remarkable progress in solving complex and logic-intensive tasks by generating extended Chain-of-Thoughts (CoTs) prior to arriving at a final answer. Yet, the emergence of this "slow-thinking" paradigm, with numerous tokens generated in sequence, inevitably introduces substantial computational overhead. To this end, it highlights an urgent need for effective acceleration. This survey aims to provide a comprehensive overview of recent advances in efficient reasoning. It categorizes existing works into three key directions: (1) shorter - compressing lengthy CoTs into concise yet effective reasoning chains; (2) smaller - developing compact language models with strong reasoning capabilities through techniques such as knowledge distillation, other model compression techniques, and reinforcement learning; and (3) faster - designing efficient decoding strategies to accelerate inference. A curated collection of papers discussed in this survey is available in our GitHub repository.

Artificial intelligence has advanced in Medical Visual Question Answering (Med-VQA), but prevalent research tends to focus on the accuracy of the answers, often overlooking the reasoning paths and interpretability, which are crucial in clinical settings. Besides, current Med-VQA algorithms, typically reliant on singular models, lack the robustness needed for real-world medical diagnostics which usually require collaborative expert evaluation. To address these shortcomings, this paper presents MedCoT, a novel hierarchical expert verification reasoning chain method designed to enhance interpretability and accuracy in biomedical imaging inquiries. MedCoT is predicated on two principles: The necessity for explicit reasoning paths in Med-VQA and the requirement for multi-expert review to formulate accurate conclusions. The methodology involves an Initial Specialist proposing diagnostic rationales, followed by a Follow-up Specialist who validates these rationales, and finally, a consensus is reached through a vote among a sparse Mixture of Experts within the locally deployed Diagnostic Specialist, which then provides the definitive diagnosis. Experimental evaluations on four standard Med-VQA datasets demonstrate that MedCoT surpasses existing state-of-the-art approaches, providing significant improvements in performance and interpretability.

Language-Image Pre-training has demonstrated promising results on zero-shot and few-shot downstream tasks by prompting visual models with natural language prompts. However, most recent studies only use a single prompt for tuning, neglecting the inherent step-to-step cognitive reasoning process that humans conduct in complex task settings, for example, when processing images from unfamiliar domains. Chain of Thought is a simple and effective approximation to human reasoning process and has been proven useful for natural language processing (NLP) tasks. Based on this cognitive intuition, we believe that conducting effective reasoning is also an important problem in visual tasks, and a chain of thought could be a solution to this problem. In this work, we propose a novel chain of thought prompt tuning for vision-language modeling. Extensive experiments show that our method not only generalizes better in image classification tasks, has greater transferability beyond a single dataset, and has stronger domain generalization performance, but also performs much better in imagetext retrieval and visual question answering, which require more reasoning capabilities. We are the first to successfully adapt chain-of-thought prompting that combines visual and textual embeddings. We will release our codes

A new prior is proposed for learning representations of high-level concepts of the kind we manipulate with language. This prior can be combined with other priors in order to help disentangling abstract factors from each other. It is inspired by cognitive neuroscience theories of consciousness, seen as a bottleneck through which just a few elements, after having been selected by attention from a broader pool, are then broadcast and condition further processing, both in perception and decision-making. The set of recently selected elements one becomes aware of is seen as forming a low-dimensional conscious state. This conscious state is combining the few concepts constituting a conscious thought, i.e., what one is immediately conscious of at a particular moment. We claim that this architectural and information-processing constraint corresponds to assumptions about the joint distribution between high-level concepts. To the extent that these assumptions are generally true (and the form of natural language seems consistent with them), they can form a useful prior for representation learning. A low-dimensional thought or conscious state is analogous to a sentence: it involves only a few variables and yet can make a statement with very high probability of being true. This is consistent with a joint distribution (over high-level concepts) which has the form of a sparse factor graph, i.e., where the dependencies captured by each factor of the factor graph involve only very few variables while creating a strong dip in the overall energy function. The consciousness prior also makes it natural to map conscious states to natural language utterances or to express classical AI knowledge in a form similar to facts and rules, albeit capturing uncertainty as well as efficient search mechanisms implemented by attention mechanisms.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

Multi-modality promises to unlock further uses for large language models. Recently, the state-of-the-art language model GPT-4 was enhanced with vision capabilities. We carry out a prompting evaluation of GPT-4V and five other baselines on structured reasoning tasks, such as mathematical reasoning, visual data analysis, and code generation. We show that visual Chain-of-Thought, an extension of Chain-of-Thought to multi-modal LLMs, yields significant improvements over the vanilla model. We also present a categorized analysis of scenarios where these models perform well and where they struggle, highlighting challenges associated with coherent multimodal reasoning.

Advancements in Large Language Models (LLMs) and their increasing use in medical question-answering necessitate rigorous evaluation of their reliability. A critical challenge lies in hallucination, where models generate plausible yet factually incorrect outputs. In the medical domain, this poses serious risks to patient safety and clinical decision-making. To address this, we introduce MedHallu, the first benchmark specifically designed for medical hallucination detection. MedHallu comprises 10,000 high-quality question-answer pairs derived from PubMedQA, with hallucinated answers systematically generated through a controlled pipeline. Our experiments show that state-of-the-art LLMs, including GPT-4o, Llama-3.1, and the medically fine-tuned UltraMedical, struggle with this binary hallucination detection task, with the best model achieving an F1 score as low as 0.625 for detecting "hard" category hallucinations. Using bidirectional entailment clustering, we show that harder-to-detect hallucinations are semantically closer to ground truth. Through experiments, we also show incorporating domain-specific knowledge and introducing a "not sure" category as one of the answer categories improves the precision and F1 scores by up to 38% relative to baselines.

Generating a Chain of Thought (CoT) has been shown to consistently improve large language model (LLM) performance on a wide range of NLP tasks. However, prior work has mainly focused on logical reasoning tasks (e.g. arithmetic, commonsense QA); it remains unclear whether improvements hold for more diverse types of reasoning, especially in socially situated contexts. Concretely, we perform a controlled evaluation of zero-shot CoT across two socially sensitive domains: harmful questions and stereotype benchmarks. We find that zero-shot CoT reasoning in sensitive domains significantly increases a model's likelihood to produce harmful or undesirable output, with trends holding across different prompt formats and model variants. Furthermore, we show that harmful CoTs increase with model size, but decrease with improved instruction following. Our work suggests that zero-shot CoT should be used with caution on socially important tasks, especially when marginalized groups or sensitive topics are involved.

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

Large language models (LLMs), while exhibiting exceptional performance, suffer from hallucinations, especially on knowledge-intensive tasks. Existing works propose to augment LLMs with individual text units retrieved from external knowledge corpora to alleviate the issue. However, in many domains, texts are interconnected (e.g., academic papers in a bibliographic graph are linked by citations and co-authorships) which form a (text-attributed) graph. The knowledge in such graphs is encoded not only in single texts/nodes but also in their associated connections. To facilitate the research of augmenting LLMs with graphs, we manually construct a Graph Reasoning Benchmark dataset called GRBench, containing 1,740 questions that can be answered with the knowledge from 10 domain graphs. Then, we propose a simple and effective framework called Graph Chain-of-thought (Graph-CoT) to augment LLMs with graphs by encouraging LLMs to reason on the graph iteratively. Each Graph-CoT iteration consists of three sub-steps: LLM reasoning, LLM-graph interaction, and graph execution. We conduct systematic experiments with three LLM backbones on GRBench, where Graph-CoT outperforms the baselines consistently. The code is available at https://github.com/PeterGriffinJin/Graph-CoT.

We provide conceptual and mathematical foundations for near-term quantum natural language processing (QNLP), and do so in quantum computer scientist friendly terms. We opted for an expository presentation style, and provide references for supporting empirical evidence and formal statements concerning mathematical generality. We recall how the quantum model for natural language that we employ canonically combines linguistic meanings with rich linguistic structure, most notably grammar. In particular, the fact that it takes a quantum-like model to combine meaning and structure, establishes QNLP as quantum-native, on par with simulation of quantum systems. Moreover, the now leading Noisy Intermediate-Scale Quantum (NISQ) paradigm for encoding classical data on quantum hardware, variational quantum circuits, makes NISQ exceptionally QNLP-friendly: linguistic structure can be encoded as a free lunch, in contrast to the apparently exponentially expensive classical encoding of grammar. Quantum speed-up for QNLP tasks has already been established in previous work with Will Zeng. Here we provide a broader range of tasks which all enjoy the same advantage. Diagrammatic reasoning is at the heart of QNLP. Firstly, the quantum model interprets language as quantum processes via the diagrammatic formalism of categorical quantum mechanics. Secondly, these diagrams are via ZX-calculus translated into quantum circuits. Parameterisations of meanings then become the circuit variables to be learned. Our encoding of linguistic structure within quantum circuits also embodies a novel approach for establishing word-meanings that goes beyond the current standards in mainstream AI, by placing linguistic structure at the heart of Wittgenstein's meaning-is-context.

Images usually convey richer detail than text, but often include redundant information which potentially downgrades multimodal reasoning performance. When faced with lengthy or complex messages, humans tend to employ abstract thinking to convert them into simple and concise abstracts. Inspired by this cognitive strategy, we introduce Visual Abstract Thinking (VAT), a novel thinking paradigm that prompts Multimodal Large Language Models (MLLMs) with visual abstract instead of explicit verbal thoughts or elaborate guidance, permitting a more concentrated visual reasoning mechanism. Explicit thinking, such as Chain-of-thought (CoT) or tool-augmented approaches, increases the complexity of reasoning process via inserting verbose intermediate steps, external knowledge or visual information. In contrast, VAT reduces redundant visual information and encourages models to focus their reasoning on more essential visual elements. Experimental results show that VAT consistently empowers different models, and achieves an average gain of 17% over GPT-4o baseline by employing diverse types of visual abstracts, demonstrating that VAT can enhance visual reasoning abilities for MLLMs regarding conceptual, structural and relational reasoning tasks. VAT is also compatible with CoT in knowledge-intensive multimodal reasoning tasks. These findings highlight the effectiveness of visual reasoning via abstract thinking and encourage further exploration of more diverse reasoning paradigms from the perspective of human cognition.

We consider the problem of model compression for deep neural networks (DNNs) in the challenging one-shot/post-training setting, in which we are given an accurate trained model, and must compress it without any retraining, based only on a small amount of calibration input data. This problem has become popular in view of the emerging software and hardware support for executing models compressed via pruning and/or quantization with speedup, and well-performing solutions have been proposed independently for both compression approaches. In this paper, we introduce a new compression framework which covers both weight pruning and quantization in a unified setting, is time- and space-efficient, and considerably improves upon the practical performance of existing post-training methods. At the technical level, our approach is based on an exact and efficient realization of the classical Optimal Brain Surgeon (OBS) framework of [LeCun, Denker, and Solla, 1990] extended to also cover weight quantization at the scale of modern DNNs. From the practical perspective, our experimental results show that it can improve significantly upon the compression-accuracy trade-offs of existing post-training methods, and that it can enable the accurate compound application of both pruning and quantization in a post-training setting.

Quantization has become a popular technique to compress neural networks and reduce compute cost, but most prior work focuses on studying quantization without changing the network size. Many real-world applications of neural networks have compute cost and memory budgets, which can be traded off with model quality by changing the number of parameters. In this work, we use ResNet as a case study to systematically investigate the effects of quantization on inference compute cost-quality tradeoff curves. Our results suggest that for each bfloat16 ResNet model, there are quantized models with lower cost and higher accuracy; in other words, the bfloat16 compute cost-quality tradeoff curve is Pareto-dominated by the 4-bit and 8-bit curves, with models primarily quantized to 4-bit yielding the best Pareto curve. Furthermore, we achieve state-of-the-art results on ImageNet for 4-bit ResNet-50 with quantization-aware training, obtaining a top-1 eval accuracy of 77.09%. We demonstrate the regularizing effect of quantization by measuring the generalization gap. The quantization method we used is optimized for practicality: It requires little tuning and is designed with hardware capabilities in mind. Our work motivates further research into optimal numeric formats for quantization, as well as the development of machine learning accelerators supporting these formats. As part of this work, we contribute a quantization library written in JAX, which is open-sourced at https://github.com/google-research/google-research/tree/master/aqt.

Digital twin technology has is anticipated to transform healthcare, enabling personalized medicines and support, earlier diagnoses, simulated treatment outcomes, and optimized surgical plans. Digital twins are readily gaining traction in industries like manufacturing, supply chain logistics, and civil infrastructure. Not in patient care, however. The challenge of modeling complex diseases with multimodal patient data and the computational complexities of analyzing it have stifled digital twin adoption in the biomedical vertical. Yet, these major obstacles can potentially be handled by approaching these models in a different way. This paper proposes a novel framework for addressing the barriers to clinical twin modeling created by computational costs and modeling complexities. We propose structuring patient health data as a knowledge graph and using closed-form continuous-time liquid neural networks, for real-time analytics. By synthesizing multimodal patient data and leveraging the flexibility and efficiency of closed form continuous time networks and knowledge graph ontologies, our approach enables real time insights, personalized medicine, early diagnosis and intervention, and optimal surgical planning. This novel approach provides a comprehensive and adaptable view of patient health along with real-time analytics, paving the way for digital twin simulations and other anticipated benefits in healthcare.

Chain-of-Thought (CoT) reasoning enables Large Language Models (LLMs) to solve complex reasoning tasks by generating intermediate reasoning steps. However, most existing approaches focus on hard token decoding, which constrains reasoning within the discrete vocabulary space and may not always be optimal. While recent efforts explore continuous-space reasoning, they often suffer from catastrophic forgetting, limiting their applicability to state-of-the-art LLMs that already perform well in zero-shot settings with a proper instruction. To address this challenge, we propose a novel approach for continuous-space reasoning that does not require modifying the underlying LLM. Specifically, we employ a lightweight assistant model to generate instance-specific soft thought tokens speculatively as the initial chain of thoughts, which are then mapped into the LLM's representation space via a projection module. Experimental results on five reasoning benchmarks demonstrate that our method enhances LLM reasoning performance through supervised, parameter-efficient fine-tuning.

Large language models' reasoning abilities benefit from methods that organize their thought processes, such as chain-of-thought prompting, which employs a sequential structure to guide the reasoning process step-by-step. However, existing approaches focus primarily on organizing the sequence of thoughts, leaving structure in individual thought steps underexplored. To address this gap, we propose Table as Thought, a framework inspired by cognitive neuroscience theories on human thought. Table as Thought organizes reasoning within a tabular schema, where rows represent sequential thought steps and columns capture critical constraints and contextual information to enhance reasoning. The reasoning process iteratively populates the table until self-verification ensures completeness and correctness. Our experiments show that Table as Thought excels in planning tasks and demonstrates a strong potential for enhancing LLM performance in mathematical reasoning compared to unstructured thought baselines. This work provides a novel exploration of refining thought representation within LLMs, paving the way for advancements in reasoning and AI cognition.

Recent advancements in the field of large language models, particularly through the Chain of Thought (CoT) approach, have demonstrated significant improvements in solving complex problems. However, existing models either tend to sacrifice detailed reasoning for brevity due to user preferences, or require extensive and expensive training data to learn complicated reasoning ability, limiting their potential in solving complex tasks. To bridge this gap, following the concept of scaling test-time, we propose a simple method by encouraging models to adopt a more patient reasoning style without the need of introducing new knowledge or skills. To employ a preference optimization approach, we generate detailed reasoning processes as positive examples and simple answers as negative examples, thereby training the model to favor thoroughness in its responses. Our results demonstrate a performance increase of up to 6.7% on GSM8k with training just on a lightweight dataset.

The remarkable capabilities of large language models (LLMs) in language understanding and generation have not rendered them immune to hallucinations. LLMs can still generate plausible-sounding but factually incorrect or fabricated information. As LLM-empowered chatbots become popular, laypeople may frequently ask health-related queries and risk falling victim to these LLM hallucinations, resulting in various societal and healthcare implications. In this work, we conduct a pioneering study of hallucinations in LLM-generated responses to real-world healthcare queries from patients. We propose MedHalu, a carefully crafted first-of-its-kind medical hallucination dataset with a diverse range of health-related topics and the corresponding hallucinated responses from LLMs with labeled hallucination types and hallucinated text spans. We also introduce MedHaluDetect framework to evaluate capabilities of various LLMs in detecting hallucinations. We also employ three groups of evaluators -- medical experts, LLMs, and laypeople -- to study who are more vulnerable to these medical hallucinations. We find that LLMs are much worse than the experts. They also perform no better than laypeople and even worse in few cases in detecting hallucinations. To fill this gap, we propose expert-in-the-loop approach to improve hallucination detection through LLMs by infusing expert reasoning. We observe significant performance gains for all the LLMs with an average macro-F1 improvement of 6.3 percentage points for GPT-4.

Recent advancements in prompt-based medical image segmentation have enabled clinicians to identify tumors using simple input like bounding boxes or text prompts. However, existing methods face challenges when doctors need to interact through natural language or when position reasoning is required - understanding spatial relationships between anatomical structures and pathologies. We present PRS-Med, a framework that integrates vision-language models with segmentation capabilities to generate both accurate segmentation masks and corresponding spatial reasoning outputs. Additionally, we introduce the MMRS dataset (Multimodal Medical in Positional Reasoning Segmentation), which provides diverse, spatially-grounded question-answer pairs to address the lack of position reasoning data in medical imaging. PRS-Med demonstrates superior performance across six imaging modalities (CT, MRI, X-ray, ultrasound, endoscopy, RGB), significantly outperforming state-of-the-art methods in both segmentation accuracy and position reasoning. Our approach enables intuitive doctor-system interaction through natural language, facilitating more efficient diagnoses. Our dataset pipeline, model, and codebase will be released to foster further research in spatially-aware multimodal reasoning for medical applications.

The coronavirus disease (COVID-19) has resulted in a pandemic crippling the a breadth of services critical to daily life. Segmentation of lung infections in computerized tomography (CT) slices could be be used to improve diagnosis and understanding of COVID-19 in patients. Deep learning systems lack interpretability because of their black box nature. Inspired by human communication of complex ideas through language, we propose a symbolic framework based on emergent languages for the segmentation of COVID-19 infections in CT scans of lungs. We model the cooperation between two artificial agents - a Sender and a Receiver. These agents synergistically cooperate using emergent symbolic language to solve the task of semantic segmentation. Our game theoretic approach is to model the cooperation between agents unlike Generative Adversarial Networks (GANs). The Sender retrieves information from one of the higher layers of the deep network and generates a symbolic sentence sampled from a categorical distribution of vocabularies. The Receiver ingests the stream of symbols and cogenerates the segmentation mask. A private emergent language is developed that forms the communication channel used to describe the task of segmentation of COVID infections. We augment existing state of the art semantic segmentation architectures with our symbolic generator to form symbolic segmentation models. Our symbolic segmentation framework achieves state of the art performance for segmentation of lung infections caused by COVID-19. Our results show direct interpretation of symbolic sentences to discriminate between normal and infected regions, infection morphology and image characteristics. We show state of the art results for segmentation of COVID-19 lung infections in CT.

In this paper, we address the challenging task of multimodal mathematical reasoning by incorporating the ability of ``slow thinking" into multimodal large language models (MLLMs). Contrary to existing methods that rely on direct or fast thinking, our key idea is to construct long chains of thought (CoT) consisting of atomic actions in a step-by-step manner, guiding MLLMs to perform complex reasoning. To this end, we design a novel AtomThink framework composed of three key modules: (i) a CoT annotation engine that automatically generates high-quality CoT annotations to address the lack of high-quality visual mathematical data; (ii) an atomic step fine-tuning strategy that jointly optimizes an MLLM and a policy reward model (PRM) for step-wise reasoning; and (iii) four different search strategies that can be applied with the PRM to complete reasoning. Additionally, we propose AtomMATH, a large-scale multimodal dataset of long CoTs, and an atomic capability evaluation metric for mathematical tasks. Extensive experimental results show that the proposed AtomThink significantly improves the performance of baseline MLLMs, achieving approximately 50\% relative accuracy gains on MathVista and 120\% on MathVerse. To support the advancement of multimodal slow-thinking models, we will make our code and dataset publicly available on https://github.com/Quinn777/AtomThink.

We explore uncertainty quantification in large language models (LLMs), with the goal to identify when uncertainty in responses given a query is large. We simultaneously consider both epistemic and aleatoric uncertainties, where the former comes from the lack of knowledge about the ground truth (such as about facts or the language), and the latter comes from irreducible randomness (such as multiple possible answers). In particular, we derive an information-theoretic metric that allows to reliably detect when only epistemic uncertainty is large, in which case the output of the model is unreliable. This condition can be computed based solely on the output of the model obtained simply by some special iterative prompting based on the previous responses. Such quantification, for instance, allows to detect hallucinations (cases when epistemic uncertainty is high) in both single- and multi-answer responses. This is in contrast to many standard uncertainty quantification strategies (such as thresholding the log-likelihood of a response) where hallucinations in the multi-answer case cannot be detected. We conduct a series of experiments which demonstrate the advantage of our formulation. Further, our investigations shed some light on how the probabilities assigned to a given output by an LLM can be amplified by iterative prompting, which might be of independent interest.

Chain-of-Thought (CoT) prompting has become the de facto method to elicit reasoning capabilities from large language models (LLMs). However, to mitigate hallucinations in CoT that are notoriously difficult to detect, current methods such as process reward models (PRMs) or self-consistency operate as opaque boxes and do not provide checkable evidence for their judgments, possibly limiting their effectiveness. To address this issue, we draw inspiration from the idea that "the gold standard for supporting a mathematical claim is to provide a proof". We propose a retrospective, step-aware formal verification framework Safe. Rather than assigning arbitrary scores, we strive to articulate mathematical claims in formal mathematical language Lean 4 at each reasoning step and provide formal proofs to identify hallucinations. We evaluate our framework Safe across multiple language models and various mathematical datasets, demonstrating a significant performance improvement while offering interpretable and verifiable evidence. We also propose FormalStep as a benchmark for step correctness theorem proving with 30,809 formal statements. To the best of our knowledge, our work represents the first endeavor to utilize formal mathematical language Lean 4 for verifying natural language content generated by LLMs, aligning with the reason why formal mathematical languages were created in the first place: to provide a robust foundation for hallucination-prone human-written proofs.

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

The rapid advancement of native multi-modal models and omni-models, exemplified by GPT-4o, Gemini, and o3, with their capability to process and generate content across modalities such as text and images, marks a significant milestone in the evolution of intelligence. Systematic evaluation of their multi-modal output capabilities in visual thinking processes (also known as multi-modal chain of thought, M-CoT) becomes critically important. However, existing benchmarks for evaluating multi-modal models primarily focus on assessing multi-modal inputs and text-only reasoning while neglecting the importance of reasoning through multi-modal outputs. In this paper, we present a benchmark, dubbed RBench-V, designed to assess models' vision-indispensable reasoning abilities. To construct RBench-V, we carefully hand-pick 803 questions covering math, physics, counting, and games. Unlike previous benchmarks that typically specify certain input modalities, RBench-V presents problems centered on multi-modal outputs, which require image manipulation such as generating novel images and constructing auxiliary lines to support the reasoning process. We evaluate numerous open- and closed-source models on RBench-V, including o3, Gemini 2.5 Pro, Qwen2.5-VL, etc. Even the best-performing model, o3, achieves only 25.8% accuracy on RBench-V, far below the human score of 82.3%, highlighting that current models struggle to leverage multi-modal reasoning. Data and code are available at https://evalmodels.github.io/rbenchv

Data scarcity is a common obstacle in medical research due to the high costs associated with data collection and the complexity of gaining access to and utilizing data. Synthesizing health data may provide an efficient and cost-effective solution to this shortage, enabling researchers to explore distributions and populations that are not represented in existing observations or difficult to access due to privacy considerations. To that end, we have developed a multi-task self-attention model that produces realistic wearable activity data. We examine the characteristics of the generated data and quantify its similarity to genuine samples with both quantitative and qualitative approaches.

This paper proposes a chatbot framework that adopts a hybrid model which consists of a knowledge graph and a text similarity model. Based on this chatbot framework, we build HHH, an online question-and-answer (QA) Healthcare Helper system for answering complex medical questions. HHH maintains a knowledge graph constructed from medical data collected from the Internet. HHH also implements a novel text representation and similarity deep learning model, Hierarchical BiLSTM Attention Model (HBAM), to find the most similar question from a large QA dataset. We compare HBAM with other state-of-the-art language models such as bidirectional encoder representation from transformers (BERT) and Manhattan LSTM Model (MaLSTM). We train and test the models with a subset of the Quora duplicate questions dataset in the medical area. The experimental results show that our model is able to achieve a superior performance than these existing methods.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

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

The advancement of Large Vision Language Models (LVLMs) has significantly improved multimodal understanding, yet challenges remain in video reasoning tasks due to the scarcity of high-quality, large-scale datasets. Existing video question-answering (VideoQA) datasets often rely on costly manual annotations with insufficient granularity or automatic construction methods with redundant frame-by-frame analysis, limiting their scalability and effectiveness for complex reasoning. To address these challenges, we introduce VideoEspresso, a novel dataset that features VideoQA pairs preserving essential spatial details and temporal coherence, along with multimodal annotations of intermediate reasoning steps. Our construction pipeline employs a semantic-aware method to reduce redundancy, followed by generating QA pairs using GPT-4o. We further develop video Chain-of-Thought (CoT) annotations to enrich reasoning processes, guiding GPT-4o in extracting logical relationships from QA pairs and video content. To exploit the potential of high-quality VideoQA pairs, we propose a Hybrid LVLMs Collaboration framework, featuring a Frame Selector and a two-stage instruction fine-tuned reasoning LVLM. This framework adaptively selects core frames and performs CoT reasoning using multimodal evidence. Evaluated on our proposed benchmark with 14 tasks against 9 popular LVLMs, our method outperforms existing baselines on most tasks, demonstrating superior video reasoning capabilities. Our code and dataset will be released at: https://github.com/hshjerry/VideoEspresso

Large Language Models (LLMs) achieve superior performance through training-time scaling, and test-time scaling further enhances their capabilities by conducting effective reasoning during inference. However, as the scale of reasoning increases, existing test-time scaling methods suffer from accumulated historical information, which not only wastes computational resources but also interferes with effective reasoning. To address this issue, we observe that complex reasoning progress is often achieved by solving a sequence of independent subquestions, each being self-contained and verifiable. These subquestions are essentially atomic questions, relying primarily on their current state rather than accumulated history, similar to the memoryless transitions in a Markov process. Based on this observation, we propose Atom of Thoughts (AoT), where each state transition in the reasoning process consists of decomposing the current question into a dependency-based directed acyclic graph and contracting its subquestions, forming a new atomic question state. This iterative decomposition-contraction process continues until reaching directly solvable atomic questions, naturally realizing Markov transitions between question states. Furthermore, these atomic questions can be seamlessly integrated into existing test-time scaling methods, enabling AoT to serve as a plug-in enhancement for improving reasoning capabilities. Experiments across six benchmarks demonstrate the effectiveness of AoT both as a standalone framework and a plug-in enhancement. Notably, on HotpotQA, when applied to gpt-4o-mini, AoT achieves an 80.6% F1 score, surpassing o3-mini by 3.4% and DeepSeek-R1 by 10.6%. The code will be available at https://github.com/qixucen/atom.

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

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

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.