Daily Papers

Federated Learning (FL) enables clients to collaboratively train a global model using their local datasets while reinforcing data privacy. However, FL is susceptible to poisoning attacks. Existing defense mechanisms assume that clients' data are independent and identically distributed (IID), making them ineffective in real-world applications where data are non-IID. This paper presents FedCLEAN, the first defense capable of filtering attackers' model updates in a non-IID FL environment. The originality of FedCLEAN is twofold. First, it relies on a client confidence score derived from the reconstruction errors of each client's model activation maps for a given trigger set, with reconstruction errors obtained by means of a Conditional Variational Autoencoder trained according to a novel server-side strategy. Second, we propose an ad-hoc trust propagation algorithm based on client scores, which allows building a cluster of benign clients while flagging potential attackers. Experimental results on the datasets MNIST and FashionMNIST demonstrate the robustness of FedCLEAN against Byzantine attackers in non-IID scenarios and a close-to-zero benign client misclassification rate, even in the absence of an attack.

This study investigates GPT-4's assessment of its performance in healthcare applications. A simple prompting technique was used to prompt the LLM with questions taken from the United States Medical Licensing Examination (USMLE) questionnaire and it was tasked to evaluate its confidence score before posing the question and after asking the question. The questionnaire was categorized into two groups-questions with feedback (WF) and questions with no feedback(NF) post-question. The model was asked to provide absolute and relative confidence scores before and after each question. The experimental findings were analyzed using statistical tools to study the variability of confidence in WF and NF groups. Additionally, a sequential analysis was conducted to observe the performance variation for the WF and NF groups. Results indicate that feedback influences relative confidence but doesn't consistently increase or decrease it. Understanding the performance of LLM is paramount in exploring its utility in sensitive areas like healthcare. This study contributes to the ongoing discourse on the reliability of AI, particularly of LLMs like GPT-4, within healthcare, offering insights into how feedback mechanisms might be optimized to enhance AI-assisted medical education and decision support.

Language models (LMs) should provide reliable confidence estimates to help users detect mistakes in their outputs and defer to human experts when necessary. Asking a language model to assess its confidence ("Score your confidence from 0-1.") is a natural way of evaluating its uncertainty. However, models struggle to provide absolute assessments of confidence (i.e. judging confidence in answering a question independent of other questions) and the coarse-grained scores they produce are not useful for evaluating the correctness of their answers. We propose relative confidence estimation, where we match up questions against each other and ask the model to make relative judgments of confidence ("Which question are you more confident in answering correctly?"). Treating each question as a "player" in a series of matchups against other questions and the model's preferences as match outcomes, we can use rank aggregation methods like Elo rating and Bradley-Terry to translate the model's confidence preferences into confidence scores. We evaluate relative confidence estimation against absolute confidence estimation and self-consistency confidence methods on five state-of-the-art LMs -- GPT-4, GPT-4o, Gemini 1.5 Pro, Claude 3.5 Sonnet, and Llama 3.1 405B -- across 14 challenging STEM, social science, and commonsense reasoning question answering tasks. Our results demonstrate that relative confidence estimation consistently provides more reliable confidence scores than absolute confidence estimation, with average gains of 3.5% in selective classification AUC over direct absolute confidence estimation methods and 1.7% over self-consistency approaches across all models and datasets.

There is a growing literature on reasoning by large language models (LLMs), but the discussion on the uncertainty in their responses is still lacking. Our aim is to assess the extent of confidence that LLMs have in their answers and how it correlates with accuracy. Confidence is measured (i) qualitatively in terms of persistence in keeping their answer when prompted to reconsider, and (ii) quantitatively in terms of self-reported confidence score. We investigate the performance of three LLMs -- GPT4o, GPT4-turbo and Mistral -- on two benchmark sets of questions on causal judgement and formal fallacies and a set of probability and statistical puzzles and paradoxes. Although the LLMs show significantly better performance than random guessing, there is a wide variability in their tendency to change their initial answers. There is a positive correlation between qualitative confidence and accuracy, but the overall accuracy for the second answer is often worse than for the first answer. There is a strong tendency to overstate the self-reported confidence score. Confidence is only partially explained by the underlying token-level probability. The material effects of prompting on qualitative confidence and the strong tendency for overconfidence indicate that current LLMs do not have any internally coherent sense of confidence.

Major cloud providers have employed advanced AI-based solutions like large language models to aid humans in identifying the root causes of cloud incidents. Despite the growing prevalence of AI-driven assistants in the root cause analysis process, their effectiveness in assisting on-call engineers is constrained by low accuracy due to the intrinsic difficulty of the task, a propensity for LLM-based approaches to hallucinate, and difficulties in distinguishing these well-disguised hallucinations. To address this challenge, we propose to perform confidence estimation for the predictions to help on-call engineers make decisions on whether to adopt the model prediction. Considering the black-box nature of many LLM-based root cause predictors, fine-tuning or temperature-scaling-based approaches are inapplicable. We therefore design an innovative confidence estimation framework based on prompting retrieval-augmented large language models (LLMs) that demand a minimal amount of information from the root cause predictor. This approach consists of two scoring phases: the LLM-based confidence estimator first evaluates its confidence in making judgments in the face of the current incident that reflects its ``grounded-ness" level in reference data, then rates the root cause prediction based on historical references. An optimization step combines these two scores for a final confidence assignment. We show that our method is able to produce calibrated confidence estimates for predicted root causes, validate the usefulness of retrieved historical data and the prompting strategy as well as the generalizability across different root cause prediction models. Our study takes an important move towards reliably and effectively embedding LLMs into cloud incident management systems.

Empowering large language models to accurately express confidence in their answers is essential for trustworthy decision-making. Previous confidence elicitation methods, which primarily rely on white-box access to internal model information or model fine-tuning, have become less suitable for LLMs, especially closed-source commercial APIs. This leads to a growing need to explore the untapped area of black-box approaches for LLM uncertainty estimation. To better break down the problem, we define a systematic framework with three components: prompting strategies for eliciting verbalized confidence, sampling methods for generating multiple responses, and aggregation techniques for computing consistency. We then benchmark these methods on two key tasks-confidence calibration and failure prediction-across five types of datasets (e.g., commonsense and arithmetic reasoning) and five widely-used LLMs including GPT-4 and LLaMA 2 Chat. Our analysis uncovers several key insights: 1) LLMs, when verbalizing their confidence, tend to be overconfident, potentially imitating human patterns of expressing confidence. 2) As model capability scales up, both calibration and failure prediction performance improve. 3) Employing our proposed strategies, such as human-inspired prompts, consistency among multiple responses, and better aggregation strategies can help mitigate this overconfidence from various perspectives. 4) Comparisons with white-box methods indicate that while white-box methods perform better, the gap is narrow, e.g., 0.522 to 0.605 in AUROC. Despite these advancements, none of these techniques consistently outperform others, and all investigated methods struggle in challenging tasks, such as those requiring professional knowledge, indicating significant scope for improvement. We believe this study can serve as a strong baseline and provide insights for eliciting confidence in black-box LLMs.

For large language models (LLMs) to be trusted by humans they need to be well-calibrated in the sense that they can accurately assess and communicate how likely it is that their predictions are correct. Recent work has focused on the quality of internal LLM confidence assessments, but the question remains of how well LLMs can communicate this internal model confidence to human users. This paper explores the disparity between external human confidence in an LLM's responses and the internal confidence of the model. Through experiments involving multiple-choice questions, we systematically examine human users' ability to discern the reliability of LLM outputs. Our study focuses on two key areas: (1) assessing users' perception of true LLM confidence and (2) investigating the impact of tailored explanations on this perception. The research highlights that default explanations from LLMs often lead to user overestimation of both the model's confidence and its' accuracy. By modifying the explanations to more accurately reflect the LLM's internal confidence, we observe a significant shift in user perception, aligning it more closely with the model's actual confidence levels. This adjustment in explanatory approach demonstrates potential for enhancing user trust and accuracy in assessing LLM outputs. The findings underscore the importance of transparent communication of confidence levels in LLMs, particularly in high-stakes applications where understanding the reliability of AI-generated information is essential.

In mental health counseling, a variety of earlier studies have focused on dialogue modeling. However, most of these studies give limited to no emphasis on the quality of interaction between a patient and a therapist. The therapeutic bond between a patient and a therapist directly correlates with effective mental health counseling. It involves developing the patient's trust on the therapist over the course of counseling. To assess the therapeutic bond in counseling, we introduce trust as a therapist-assistive metric. Our definition of trust involves patients' willingness and openness to express themselves and, consequently, receive better care. We conceptualize it as a dynamic trajectory observable through textual interactions during the counseling. To facilitate trust modeling, we present MENTAL-TRUST, a novel counseling dataset comprising manual annotation of 212 counseling sessions with first-of-its-kind seven expert-verified ordinal trust levels. We project our problem statement as an ordinal classification task for trust quantification and propose a new benchmark, TrustBench, comprising a suite of classical and state-of-the-art language models on MENTAL-TRUST. We evaluate the performance across a suite of metrics and lay out an exhaustive set of findings. Our study aims to unfold how trust evolves in therapeutic interactions.

A trustworthy real-world prediction system should produce well-calibrated confidence scores; that is, its confidence in an answer should be indicative of the likelihood that the answer is correct, enabling deferral to an expert in cases of low-confidence predictions. Recent studies have shown that unsupervised pre-training produces large language models (LMs) whose conditional probabilities are remarkably well-calibrated. However, the most widely-used LMs are fine-tuned with reinforcement learning from human feedback (RLHF-LMs), and some studies have suggested that RLHF-LMs produce conditional probabilities that are very poorly calibrated. In light of this perceived weakness, we conduct a broad evaluation of methods for extracting confidence scores from RLHF-LMs. For RLHF-LMs such as ChatGPT, GPT-4, and Claude, we find that verbalized confidences emitted as output tokens are typically better-calibrated than the model's conditional probabilities on the TriviaQA, SciQ, and TruthfulQA benchmarks, often reducing the expected calibration error by a relative 50%.

This study explores the use of LLMs for providing quantitative zero-shot sentiment analysis of implicit software desirability, addressing a critical challenge in product evaluation where traditional review scores, though convenient, fail to capture the richness of qualitative user feedback. Innovations include establishing a method that 1) works with qualitative user experience data without the need for explicit review scores, 2) focuses on implicit user satisfaction, and 3) provides scaled numerical sentiment analysis, offering a more nuanced understanding of user sentiment, instead of simply classifying sentiment as positive, neutral, or negative. Data is collected using the Microsoft Product Desirability Toolkit (PDT), a well-known qualitative user experience analysis tool. For initial exploration, the PDT metric was given to users of two software systems. PDT data was fed through several LLMs (Claude Sonnet 3 and 3.5, GPT4, and GPT4o) and through a leading transfer learning technique, Twitter-Roberta-Base-Sentiment, and Vader, a leading sentiment analysis tool. Each system was asked to evaluate the data in two ways, by looking at the sentiment expressed in the PDT word/explanation pairs; and by looking at the sentiment expressed by the users in their grouped selection of five words and explanations, as a whole. Each LLM provided a sentiment score, its confidence (low, medium, high) in the score, and an explanation of the score. All LLMs tested were able to statistically detect user sentiment from the users' grouped data, whereas TRBS and Vader were not. The confidence and explanation of confidence provided by the LLMs assisted in understanding user sentiment. This study adds deeper understanding of evaluating user experiences, toward the goal of creating a universal tool that quantifies implicit sentiment.

Increasing test-time computation is a straightforward approach to enhancing the quality of responses in Large Language Models (LLMs). While Best-of-N sampling and Self-Consistency with majority voting are simple and effective, they require a fixed number of sampling responses for each query, regardless of its complexity. This could result in wasted computation for simpler questions and insufficient exploration for more challenging ones. In this work, we argue that model confidence of responses can be used for improving the efficiency of test-time scaling. Unfortunately, LLMs are known to be overconfident and provide unreliable confidence estimation. To address this limitation, we introduce Self-Calibration by distilling Self-Consistency-derived confidence into the model itself. This enables reliable confidence estimation at test time with one forward pass. We then design confidence-based efficient test-time scaling methods to handle queries of various difficulty, such as Early-Stopping for Best-of-N and Self-Consistency with calibrated confidence. Experiments on three LLMs across six datasets demonstrate the effectiveness of our approach. Specifically, applying confidence-based Early Stopping to Best-of-N improves MathQA accuracy from 81.0 to 83.6 with a sample budget of 16 responses, indicating the efficacy of confidence-based sampling strategy at inference time.

Zero-shot LLMs are now also used for textual classification tasks, e.g., sentiment/emotion detection of a given input as a sentence/article. However, their performance can be suboptimal in such data annotation tasks. We introduce a novel technique Perceived Confidence Scoring (PCS) that evaluates LLM's confidence for its classification of an input by leveraging Metamorphic Relations (MRs). The MRs generate semantically equivalent yet textually mutated versions of the input. Following the principles of Metamorphic Testing (MT), the mutated versions are expected to have annotation labels similar to the input. By analyzing the consistency of LLM responses across these variations, PCS computes a confidence score based on the frequency of predicted labels. PCS can be used both for single LLM and multiple LLM settings (e.g., majority voting). We introduce an algorithm Perceived Differential Evolution (PDE) that determines the optimal weights assigned to the MRs and the LLMs for a classification task. Empirical evaluation shows PCS significantly improves zero-shot accuracy for Llama-3-8B-Instruct (4.96%) and Mistral-7B-Instruct-v0.3 (10.52%), with Gemma-2-9b-it showing a 9.39% gain. When combining all three models, PCS significantly outperforms majority voting by 7.75%.

We introduce BSDetector, a method for detecting bad and speculative answers from a pretrained Large Language Model by estimating a numeric confidence score for any output it generated. Our uncertainty quantification technique works for any LLM accessible only via a black-box API, whose training data remains unknown. By expending a bit of extra computation, users of any LLM API can now get the same response as they would ordinarily, as well as a confidence estimate that cautions when not to trust this response. Experiments on both closed and open-form Question-Answer benchmarks reveal that BSDetector more accurately identifies incorrect LLM responses than alternative uncertainty estimation procedures (for both GPT-3 and ChatGPT). By sampling multiple responses from the LLM and considering the one with the highest confidence score, we can additionally obtain more accurate responses from the same LLM, without any extra training steps. In applications involving automated evaluation with LLMs, accounting for our confidence scores leads to more reliable evaluation in both human-in-the-loop and fully-automated settings (across both GPT 3.5 and 4).

Determining whether inputs are out-of-distribution (OOD) is an essential building block for safely deploying machine learning models in the open world. However, previous methods relying on the softmax confidence score suffer from overconfident posterior distributions for OOD data. We propose a unified framework for OOD detection that uses an energy score. We show that energy scores better distinguish in- and out-of-distribution samples than the traditional approach using the softmax scores. Unlike softmax confidence scores, energy scores are theoretically aligned with the probability density of the inputs and are less susceptible to the overconfidence issue. Within this framework, energy can be flexibly used as a scoring function for any pre-trained neural classifier as well as a trainable cost function to shape the energy surface explicitly for OOD detection. On a CIFAR-10 pre-trained WideResNet, using the energy score reduces the average FPR (at TPR 95%) by 18.03% compared to the softmax confidence score. With energy-based training, our method outperforms the state-of-the-art on common benchmarks.

Modern ML systems ingest data aggregated from diverse sources, such as synthetic, human-annotated, and live customer traffic. Understanding which examples are important to the performance of a learning algorithm is crucial for efficient model training. Recently, a growing body of literature has given rise to various "influence scores," which use training artifacts such as model confidence or checkpointed gradients to identify important subsets of data. However, these methods have primarily been developed in computer vision settings, and it remains unclear how well they generalize to language-based tasks using pretrained models. In this paper, we explore the applicability of influence scores in language classification tasks. We evaluate a diverse subset of these scores on the SNLI dataset by quantifying accuracy changes in response to pruning training data through random and influence-score-based sampling. We then stress-test one of the scores -- "variance of gradients" (VoG) from Agarwal et al. (2022) -- in an NLU model stack that was exposed to dynamic user speech patterns in a voice assistant type of setting. Our experiments demonstrate that in many cases, encoder-based language models can be finetuned on roughly 50% of the original data without degradation in performance metrics. Along the way, we summarize lessons learned from applying out-of-the-box implementations of influence scores, quantify the effects of noisy and class-imbalanced data, and offer recommendations on score-based sampling for better accuracy and training efficiency.

Retrieval Augmented Generation (RAG) complements the knowledge of Large Language Models (LLMs) by leveraging external information to enhance response accuracy for queries. This approach is widely applied in several fields by taking its advantage of injecting the most up-to-date information, and researchers are focusing on understanding and improving this aspect to unlock the full potential of RAG in such high-stakes applications. However, despite the potential of RAG to address these needs, the mechanisms behind the confidence levels of its outputs remain underexplored, although the confidence of information is very critical in some domains, such as finance, healthcare, and medicine. Our study focuses the impact of RAG on confidence within the medical domain under various configurations and models. We evaluate confidence by treating the model's predicted probability as its output and calculating Expected Calibration Error (ECE) and Adaptive Calibration Error (ACE) scores based on the probabilities and accuracy. In addition, we analyze whether the order of retrieved documents within prompts calibrates the confidence. Our findings reveal large variation in confidence and accuracy depending on the model, settings, and the format of input prompts. These results underscore the necessity of optimizing configurations based on the specific model and conditions.

This study investigates the consistency of feedback ratings generated by OpenAI's GPT-4, a state-of-the-art artificial intelligence language model, across multiple iterations, time spans and stylistic variations. The model rated responses to tasks within the Higher Education (HE) subject domain of macroeconomics in terms of their content and style. Statistical analysis was conducted in order to learn more about the interrater reliability, consistency of the ratings across iterations and the correlation between ratings in terms of content and style. The results revealed a high interrater reliability with ICC scores ranging between 0.94 and 0.99 for different timespans, suggesting that GPT-4 is capable of generating consistent ratings across repetitions with a clear prompt. Style and content ratings show a high correlation of 0.87. When applying a non-adequate style the average content ratings remained constant, while style ratings decreased, which indicates that the large language model (LLM) effectively distinguishes between these two criteria during evaluation. The prompt used in this study is furthermore presented and explained. Further research is necessary to assess the robustness and reliability of AI models in various use cases.

Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client's actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client's motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

One of the most widely used methods to evaluate LLMs are Multiple Choice Question (MCQ) tests. MCQ benchmarks enable the testing of LLM knowledge on almost any topic at scale as the results can be processed automatically. To help the LLM answer, a few examples called few shots can be included in the prompt. Moreover, the LLM can be asked to answer the question directly with the selected option or to first provide the reasoning and then the selected answer, which is known as chain of thought. In addition to checking whether the selected answer is correct, the evaluation can look at the LLM-estimated probability of its response as an indication of the confidence of the LLM in the response. In this paper, we study how the LLM confidence in its answer depends on whether the model has been asked to answer directly or to provide the reasoning before answering. The results of the evaluation of questions on a wide range of topics in seven different models show that LLMs are more confident in their answers when they provide reasoning before the answer. This occurs regardless of whether the selected answer is correct. Our hypothesis is that this behavior is due to the reasoning that modifies the probability of the selected answer, as the LLM predicts the answer based on the input question and the reasoning that supports the selection made. Therefore, LLM estimated probabilities seem to have intrinsic limitations that should be understood in order to use them in evaluation procedures. Interestingly, the same behavior has been observed in humans, for whom explaining an answer increases confidence in its correctness.

Large language models (LLMs) have demonstrated impressive performance on several tasks and are increasingly deployed in real-world applications. However, especially in high-stakes settings, it becomes vital to know when the output of an LLM may be unreliable. Depending on whether an answer is trustworthy, a system can then choose to route the question to another expert, or otherwise fall back on a safe default behavior. In this work, we study the extent to which LLMs can reliably indicate confidence in their answers, and how this notion of confidence can translate into downstream accuracy gains. We propose Self-REF, a lightweight training strategy to teach LLMs to express confidence in whether their answers are correct in a reliable manner. Self-REF introduces confidence tokens into the LLM, from which a confidence score can be extracted. Compared to conventional approaches such as verbalizing confidence and examining token probabilities, we demonstrate empirically that confidence tokens show significant improvements in downstream routing and rejection learning tasks.

Objective: We investigate whether deep learning techniques for natural language processing (NLP) can be used efficiently for patient phenotyping. Patient phenotyping is a classification task for determining whether a patient has a medical condition, and is a crucial part of secondary analysis of healthcare data. We assess the performance of deep learning algorithms and compare them with classical NLP approaches. Materials and Methods: We compare convolutional neural networks (CNNs), n-gram models, and approaches based on cTAKES that extract pre-defined medical concepts from clinical notes and use them to predict patient phenotypes. The performance is tested on 10 different phenotyping tasks using 1,610 discharge summaries extracted from the MIMIC-III database. Results: CNNs outperform other phenotyping algorithms in all 10 tasks. The average F1-score of our model is 76 (PPV of 83, and sensitivity of 71) with our model having an F1-score up to 37 points higher than alternative approaches. We additionally assess the interpretability of our model by presenting a method that extracts the most salient phrases for a particular prediction. Conclusion: We show that NLP methods based on deep learning improve the performance of patient phenotyping. Our CNN-based algorithm automatically learns the phrases associated with each patient phenotype. As such, it reduces the annotation complexity for clinical domain experts, who are normally required to develop task-specific annotation rules and identify relevant phrases. Our method performs well in terms of both performance and interpretability, which indicates that deep learning is an effective approach to patient phenotyping based on clinicians' notes.

To maintain user trust, large language models (LLMs) should signal low confidence on examples where they are incorrect, instead of misleading the user. The standard approach of estimating confidence is to use the softmax probabilities of these models, but as of November 2023, state-of-the-art LLMs such as GPT-4 and Claude-v1.3 do not provide access to these probabilities. We first study eliciting confidence linguistically -- asking an LLM for its confidence in its answer -- which performs reasonably (80.5% AUC on GPT-4 averaged across 12 question-answering datasets -- 7% above a random baseline) but leaves room for improvement. We then explore using a surrogate confidence model -- using a model where we do have probabilities to evaluate the original model's confidence in a given question. Surprisingly, even though these probabilities come from a different and often weaker model, this method leads to higher AUC than linguistic confidences on 9 out of 12 datasets. Our best method composing linguistic confidences and surrogate model probabilities gives state-of-the-art confidence estimates on all 12 datasets (84.6% average AUC on GPT-4).

This research tests the role of Large Language Models (LLMs) as formal second opinion tools in professional decision-making, particularly focusing on complex medical cases where even experienced physicians seek peer consultation. The work analyzed 183 challenging medical cases from Medscape over a 20-month period, testing multiple LLMs' performance against crowd-sourced physician responses. A key finding was the high overall score possible in the latest foundational models (>80% accuracy compared to consensus opinion), which exceeds most human metrics reported on the same clinical cases (450 pages of patient profiles, test results). The study rates the LLMs' performance disparity between straightforward cases (>81% accuracy) and complex scenarios (43% accuracy), particularly in these cases generating substantial debate among human physicians. The research demonstrates that LLMs may be valuable as generators of comprehensive differential diagnoses rather than as primary diagnostic tools, potentially helping to counter cognitive biases in clinical decision-making, reduce cognitive loads, and thus remove some sources of medical error. The inclusion of a second comparative legal dataset (Supreme Court cases, N=21) provides added empirical context to the AI use to foster second opinions, though these legal challenges proved considerably easier for LLMs to analyze. In addition to the original contributions of empirical evidence for LLM accuracy, the research aggregated a novel benchmark for others to score highly contested question and answer reliability between both LLMs and disagreeing human practitioners. These results suggest that the optimal deployment of LLMs in professional settings may differ substantially from current approaches that emphasize automation of routine tasks.

Applying large language models (LLMs) to assist in psycho-counseling is an emerging and meaningful approach, driven by the significant gap between patient needs and the availability of mental health support. However, current LLMs struggle to consistently provide effective responses to client speeches, largely due to the lack of supervision from high-quality real psycho-counseling data, whose content is typically inaccessible due to client privacy concerns. Furthermore, the quality of therapists' responses in available sessions can vary significantly based on their professional training and experience. Assessing the quality of therapists' responses remains an open challenge. In this work, we address these challenges by first proposing a set of professional and comprehensive principles to evaluate therapists' responses to client speeches. Using these principles, we create a preference dataset, PsychoCounsel-Preference, which contains 36k high-quality preference comparison pairs. This dataset aligns with the preferences of professional psychotherapists, providing a robust foundation for evaluating and improving LLMs in psycho-counseling. Experiments on reward modeling and preference learning demonstrate that PsychoCounsel-Preference is an excellent resource for LLMs to acquire essential skills for responding to clients in a counseling session. Our best-aligned model, PsychoCounsel-Llama3-8B, achieves an impressive win rate of 87% against GPT-4o. We release PsychoCounsel-Preference, PsychoCounsel-Llama3-8B and the reward model PsychoCounsel Llama3-8B-Reward to facilitate the research of psycho-counseling with LLMs at: https://hf.co/Psychotherapy-LLM.

The evaluation of Large Language Models (LLMs) in healthcare has been dominated by physician-centric, English-language benchmarks, creating a dangerous illusion of competence that ignores the interprofessional nature of patient care. To provide a more holistic and realistic assessment, we introduce HealthQA-BR, the first large-scale, system-wide benchmark for Portuguese-speaking healthcare. Comprising 5,632 questions from Brazil's national licensing and residency exams, it uniquely assesses knowledge not only in medicine and its specialties but also in nursing, dentistry, psychology, social work, and other allied health professions. We conducted a rigorous zero-shot evaluation of over 20 leading LLMs. Our results reveal that while state-of-the-art models like GPT 4.1 achieve high overall accuracy (86.6%), this top-line score masks alarming, previously unmeasured deficiencies. A granular analysis shows performance plummets from near-perfect in specialties like Ophthalmology (98.7%) to barely passing in Neurosurgery (60.0%) and, most notably, Social Work (68.4%). This "spiky" knowledge profile is a systemic issue observed across all models, demonstrating that high-level scores are insufficient for safety validation. By publicly releasing HealthQA-BR and our evaluation suite, we provide a crucial tool to move beyond single-score evaluations and toward a more honest, granular audit of AI readiness for the entire healthcare team.

Comprehensive evaluations of language models (LM) during both development and deployment phases are necessary because these models possess numerous capabilities (e.g., mathematical reasoning, legal support, or medical diagnostic) as well as safety risks (e.g., racial bias, toxicity, or misinformation). The average score across a wide range of benchmarks provides a signal that helps guide the use of these LMs in practice. Currently, holistic evaluations are costly due to the large volume of benchmark questions, making frequent evaluations impractical. A popular attempt to lower the cost is to compute the average score on a subset of the benchmark. This approach, unfortunately, often renders an unreliable measure of LM performance because the average score is often confounded with the difficulty of the questions in the benchmark subset. Item response theory (IRT) was designed to address this challenge, providing a reliable measurement by careful controlling for question difficulty. Unfortunately, question difficulty is expensive to estimate. Facing this challenge, we train a model that predicts question difficulty from its content, enabling a reliable measurement at a fraction of the cost. In addition, we leverage this difficulty predictor to further improve the evaluation efficiency through training a question generator given a difficulty level. This question generator is essential in adaptive testing, where, instead of using a random subset of the benchmark questions, informative questions are adaptively chosen based on the current estimation of LLM performance. Experiments on 22 common natural language benchmarks and 172 LMs show that this approach is more reliable and efficient compared to current common practice.

Scaling the test-time compute of large language models has demonstrated impressive performance on reasoning benchmarks. However, existing evaluations of test-time scaling make the strong assumption that a reasoning system should always give an answer to any question provided. This overlooks concerns about whether a model is confident in its answer, and whether it is appropriate to always provide a response. To address these concerns, we extract confidence scores during reasoning for thresholding model responses. We find that increasing compute budget at inference time not only helps models answer more questions correctly, but also increases confidence in correct responses. We then extend the current paradigm of zero-risk responses during evaluation by considering settings with non-zero levels of response risk, and suggest a recipe for reporting evaluations under these settings.

How to ensure fairness is an important topic in federated learning (FL). Recent studies have investigated how to reward clients based on their contribution (collaboration fairness), and how to achieve uniformity of performance across clients (performance fairness). Despite achieving progress on either one, we argue that it is critical to consider them together, in order to engage and motivate more diverse clients joining FL to derive a high-quality global model. In this work, we propose a novel method to optimize both types of fairness simultaneously. Specifically, we propose to estimate client contribution in gradient and data space. In gradient space, we monitor the gradient direction differences of each client with respect to others. And in data space, we measure the prediction error on client data using an auxiliary model. Based on this contribution estimation, we propose a FL method, federated training via contribution estimation (FedCE), i.e., using estimation as global model aggregation weights. We have theoretically analyzed our method and empirically evaluated it on two real-world medical datasets. The effectiveness of our approach has been validated with significant performance improvements, better collaboration fairness, better performance fairness, and comprehensive analytical studies.

When answering questions, LLMs can convey not only an answer, but a level of confidence about the answer being correct. This includes explicit confidence markers (e.g. giving a numeric score) as well as implicit markers, like an authoritative tone or elaborating with additional knowledge. For LLMs to be trustworthy knowledge sources, the confidence they convey should match their actual expertise; however, most current models tend towards overconfidence. To calibrate both implicit and explicit confidence markers, we introduce a pragmatic, listener-aware finetuning method (LACIE) that models the listener, considering not only whether an answer is right, but whether it will be accepted by a listener. We cast calibration as preference optimization, creating data via a two-agent game, where a speaker model's outputs are judged by a simulated listener. We then finetune three LLMs (Mistral-7B, Llama3-8B, Llama3-70B) with LACIE, and show that the resulting models are better calibrated w.r.t. a simulated listener. Crucially, these trends transfer to human listeners, helping them correctly predict model correctness: we conduct a human evaluation where annotators accept or reject an LLM's answers, finding that training with LACIE results in 47% fewer incorrect answers being accepted while maintaining the same level of acceptance for correct answers. Furthermore, LACIE generalizes to another dataset, resulting in a large increase in truthfulness on TruthfulQA when trained on TriviaQA. Our analysis indicates that LACIE leads to a better confidence separation between correct and incorrect examples. Qualitatively, we find that a LACIE-trained model hedges more and implicitly signals certainty when it is correct by using an authoritative tone or including details. Finally, LACIE finetuning leads to an emergent increase in model abstention (e.g. saying "I don't know") for answers that are likely wrong.

Estimating uncertainty or confidence in the responses of a model can be significant in evaluating trust not only in the responses, but also in the model as a whole. In this paper, we explore the problem of estimating confidence for responses of large language models (LLMs) with simply black-box or query access to them. We propose a simple and extensible framework where, we engineer novel features and train a (interpretable) model (viz. logistic regression) on these features to estimate the confidence. We empirically demonstrate that our simple framework is effective in estimating confidence of flan-ul2, llama-13b and mistral-7b with it consistently outperforming existing black-box confidence estimation approaches on benchmark datasets such as TriviaQA, SQuAD, CoQA and Natural Questions by even over 10% (on AUROC) in some cases. Additionally, our interpretable approach provides insight into features that are predictive of confidence, leading to the interesting and useful discovery that our confidence models built for one LLM generalize zero-shot across others on a given dataset.

Model evolution and constant availability of data are two common phenomena in large-scale real-world machine learning applications, e.g. ads and recommendation systems. To adapt, the real-world system typically retrain with all available data and online learn with recently available data to update the models periodically with the goal of better serving performance. In this paper, we propose a novel framework, named Confidence Ranking, which designs the optimization objective as a ranking function with two different models. Our confidence ranking loss allows direct optimization of the logits output for different convex surrogate functions of metrics, e.g. AUC and Accuracy depending on the target task and dataset. Armed with our proposed methods, our experiments show that the introduction of confidence ranking loss can outperform all baselines on the CTR prediction tasks of public and industrial datasets. This framework has been deployed in the advertisement system of JD.com to serve the main traffic in the fine-rank stage.

Mental health research through data-driven methods has been hindered by a lack of standard typology and scarcity of adequate data. In this study, we leverage the clinical articulation of depression to build a typology for social media texts for detecting the severity of depression. It emulates the standard clinical assessment procedure Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and Patient Health Questionnaire (PHQ-9) to encompass subtle indications of depressive disorders from tweets. Along with the typology, we present a new dataset of 40191 tweets labeled by expert annotators. Each tweet is labeled as 'non-depressed' or 'depressed'. Moreover, three severity levels are considered for 'depressed' tweets: (1) mild, (2) moderate, and (3) severe. An associated confidence score is provided with each label to validate the quality of annotation. We examine the quality of the dataset via representing summary statistics while setting strong baseline results using attention-based models like BERT and DistilBERT. Finally, we extensively address the limitations of the study to provide directions for further research.

Nearly all jurisdictions in the United States require a professional license exam, commonly referred to as "the Bar Exam," as a precondition for law practice. To even sit for the exam, most jurisdictions require that an applicant completes at least seven years of post-secondary education, including three years at an accredited law school. In addition, most test-takers also undergo weeks to months of further, exam-specific preparation. Despite this significant investment of time and capital, approximately one in five test-takers still score under the rate required to pass the exam on their first try. In the face of a complex task that requires such depth of knowledge, what, then, should we expect of the state of the art in "AI?" In this research, we document our experimental evaluation of the performance of OpenAI's `text-davinci-003` model, often-referred to as GPT-3.5, on the multistate multiple choice (MBE) section of the exam. While we find no benefit in fine-tuning over GPT-3.5's zero-shot performance at the scale of our training data, we do find that hyperparameter optimization and prompt engineering positively impacted GPT-3.5's zero-shot performance. For best prompt and parameters, GPT-3.5 achieves a headline correct rate of 50.3% on a complete NCBE MBE practice exam, significantly in excess of the 25% baseline guessing rate, and performs at a passing rate for both Evidence and Torts. GPT-3.5's ranking of responses is also highly-correlated with correctness; its top two and top three choices are correct 71% and 88% of the time, respectively, indicating very strong non-entailment performance. While our ability to interpret these results is limited by nascent scientific understanding of LLMs and the proprietary nature of GPT, we believe that these results strongly suggest that an LLM will pass the MBE component of the Bar Exam in the near future.

Next token prediction paradigm has been prevailing for autoregressive models in the era of LLMs. The current default sampling choice for popular LLMs is temperature scaling together with nucleus sampling to balance diversity and coherence. Nevertheless, such approach leads to inferior performance in various NLP tasks when the model is not certain about testing questions. To this end, we propose a brand new training-free decoding strategy, dubbed as Cautious Next Token Prediction (CNTP). In the decoding process, if the model has comparatively high prediction entropy at a certain step, we sample multiple trials starting from the step independently and stop when encountering any punctuation. Then we select the trial with the lowest perplexity score viewed as the most probable and reliable trial path given the model's capacity. The trial number is negatively correlated with the prediction confidence, i.e., the less confident the model is, the more trials it should sample. This is consistent with human beings' behaviour: when feeling uncertain or unconfident, one tends to think more creatively, exploring multiple thinking paths, to cautiously select the path one feels most confident about. Extensive experiments on both LLMs and MLLMs show that our proposed CNTP approach outperforms existing standard decoding strategies consistently by a clear margin. Moreover, the integration of CNTP with self consistency can further improve over vanilla self consistency. We believe our proposed CNTP has the potential to become one of the default choices for LLM decoding. Code is available at https://github.com/wyzjack/CNTP.

Millions of people participate in online peer-to-peer support sessions, yet there has been little prior research on systematic psychology-based evaluations of fine-grained peer-counselor behavior in relation to client satisfaction. This paper seeks to bridge this gap by mapping peer-counselor chat-messages to motivational interviewing (MI) techniques. We annotate 14,797 utterances from 734 chat conversations using 17 MI techniques and introduce four new interviewing codes such as chit-chat and inappropriate to account for the unique conversational patterns observed on online platforms. We automate the process of labeling peer-counselor responses to MI techniques by fine-tuning large domain-specific language models and then use these automated measures to investigate the behavior of the peer counselors via correlational studies. Specifically, we study the impact of MI techniques on the conversation ratings to investigate the techniques that predict clients' satisfaction with their counseling sessions. When counselors use techniques such as reflection and affirmation, clients are more satisfied. Examining volunteer counselors' change in usage of techniques suggest that counselors learn to use more introduction and open questions as they gain experience. This work provides a deeper understanding of the use of motivational interviewing techniques on peer-to-peer counselor platforms and sheds light on how to build better training programs for volunteer counselors on online platforms.

The global economy is increasingly dependent on knowledge workers to meet the needs of public and private organizations. While there is no single definition of knowledge work, organizations and industry groups still attempt to measure individuals' capability to engage in it. The most comprehensive assessment of capability readiness for professional knowledge workers is the Uniform CPA Examination developed by the American Institute of Certified Public Accountants (AICPA). In this paper, we experimentally evaluate OpenAI's `text-davinci-003` and prior versions of GPT on both a sample Regulation (REG) exam and an assessment of over 200 multiple-choice questions based on the AICPA Blueprints for legal, financial, accounting, technology, and ethical tasks. First, we find that `text-davinci-003` achieves a correct rate of 14.4% on a sample REG exam section, significantly underperforming human capabilities on quantitative reasoning in zero-shot prompts. Second, `text-davinci-003` appears to be approaching human-level performance on the Remembering & Understanding and Application skill levels in the Exam absent calculation. For best prompt and parameters, the model answers 57.6% of questions correctly, significantly better than the 25% guessing rate, and its top two answers are correct 82.1% of the time, indicating strong non-entailment. Finally, we find that recent generations of GPT-3 demonstrate material improvements on this assessment, rising from 30% for `text-davinci-001` to 57% for `text-davinci-003`. These findings strongly suggest that large language models have the potential to transform the quality and efficiency of future knowledge work.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Current question-answering benchmarks predominantly focus on accuracy in realizable prediction tasks. Conditioned on a question and answer-key, does the most likely token match the ground truth? Such benchmarks necessarily fail to evaluate LLMs' ability to quantify ground-truth outcome uncertainty. In this work, we focus on the use of LLMs as risk scores for unrealizable prediction tasks. We introduce folktexts, a software package to systematically generate risk scores using LLMs, and evaluate them against US Census data products. A flexible API enables the use of different prompting schemes, local or web-hosted models, and diverse census columns that can be used to compose custom prediction tasks. We evaluate 17 recent LLMs across five proposed benchmark tasks. We find that zero-shot risk scores produced by multiple-choice question-answering have high predictive signal but are widely miscalibrated. Base models consistently overestimate outcome uncertainty, while instruction-tuned models underestimate uncertainty and produce over-confident risk scores. In fact, instruction-tuning polarizes answer distribution regardless of true underlying data uncertainty. This reveals a general inability of instruction-tuned LLMs to express data uncertainty using multiple-choice answers. A separate experiment using verbalized chat-style risk queries yields substantially improved calibration across instruction-tuned models. These differences in ability to quantify data uncertainty cannot be revealed in realizable settings, and highlight a blind-spot in the current evaluation ecosystem that folktexts covers.

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

Machine learning models are widely used, but can also often be wrong. Users would benefit from a reliable indication of whether a given output from a given model should be trusted, so a rational decision can be made whether to use the output or not. For example, outputs can be associated with a confidence measure; if this confidence measure is strongly associated with likelihood of correctness, then the model is said to be well-calibrated. A well-calibrated confidence measure can serve as a basis for rational, graduated decision-making on how much review and care is needed when using generated code. Calibration has so far been studied in mostly non-generative (e.g. classification) settings, especially in software engineering. However, generated code can quite often be wrong: Given generated code, developers must decide whether to use directly, use after varying intensity of careful review, or discard model-generated code. Thus, calibration is vital in generative settings. We make several contributions. We develop a framework for evaluating the calibration of code-generating models. We consider several tasks, correctness criteria, datasets, and approaches, and find that, by and large, generative code models we test are not well-calibrated out of the box. We then show how calibration can be improved using standard methods, such as Platt scaling. Since Platt scaling relies on the prior availability of correctness data, we evaluate the applicability and generalizability of Platt scaling in software engineering, discuss settings where it has good potential for practical use, and settings where it does not. Our contributions will lead to better-calibrated decision-making in the current use of code generated by language models, and offers a framework for future research to further improve calibration methods for generative models in software engineering.

We present a comprehensive evaluation of proprietary and open-weights large language models using the first astronomy-specific benchmarking dataset. This dataset comprises 4,425 multiple-choice questions curated from the Annual Review of Astronomy and Astrophysics, covering a broad range of astrophysical topics. Our analysis examines model performance across various astronomical subfields and assesses response calibration, crucial for potential deployment in research environments. Claude-3.5-Sonnet outperforms competitors by up to 4.6 percentage points, achieving 85.0% accuracy. For proprietary models, we observed a universal reduction in cost every 3-to-12 months to achieve similar score in this particular astronomy benchmark. Open-source models have rapidly improved, with LLaMA-3-70b (80.6%) and Qwen-2-72b (77.7%) now competing with some of the best proprietary models. We identify performance variations across topics, with non-English-focused models generally struggling more in exoplanet-related fields, stellar astrophysics, and instrumentation related questions. These challenges likely stem from less abundant training data, limited historical context, and rapid recent developments in these areas. This pattern is observed across both open-weights and proprietary models, with regional dependencies evident, highlighting the impact of training data diversity on model performance in specialized scientific domains. Top-performing models demonstrate well-calibrated confidence, with correlations above 0.9 between confidence and correctness, though they tend to be slightly underconfident. The development for fast, low-cost inference of open-weights models presents new opportunities for affordable deployment in astronomy. The rapid progress observed suggests that LLM-driven research in astronomy may become feasible in the near future.

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

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

This paper introduces the UCFE: User-Centric Financial Expertise benchmark, an innovative framework designed to evaluate the ability of large language models (LLMs) to handle complex real-world financial tasks. UCFE benchmark adopts a hybrid approach that combines human expert evaluations with dynamic, task-specific interactions to simulate the complexities of evolving financial scenarios. Firstly, we conducted a user study involving 804 participants, collecting their feedback on financial tasks. Secondly, based on this feedback, we created our dataset that encompasses a wide range of user intents and interactions. This dataset serves as the foundation for benchmarking 12 LLM services using the LLM-as-Judge methodology. Our results show a significant alignment between benchmark scores and human preferences, with a Pearson correlation coefficient of 0.78, confirming the effectiveness of the UCFE dataset and our evaluation approach. UCFE benchmark not only reveals the potential of LLMs in the financial sector but also provides a robust framework for assessing their performance and user satisfaction.The benchmark dataset and evaluation code are available.

There is a significant gap between patient needs and available mental health support today. In this paper, we aim to thoroughly examine the potential of using Large Language Models (LLMs) to assist professional psychotherapy. To this end, we propose a new benchmark, CBT-BENCH, for the systematic evaluation of cognitive behavioral therapy (CBT) assistance. We include three levels of tasks in CBT-BENCH: I: Basic CBT knowledge acquisition, with the task of multiple-choice questions; II: Cognitive model understanding, with the tasks of cognitive distortion classification, primary core belief classification, and fine-grained core belief classification; III: Therapeutic response generation, with the task of generating responses to patient speech in CBT therapy sessions. These tasks encompass key aspects of CBT that could potentially be enhanced through AI assistance, while also outlining a hierarchy of capability requirements, ranging from basic knowledge recitation to engaging in real therapeutic conversations. We evaluated representative LLMs on our benchmark. Experimental results indicate that while LLMs perform well in reciting CBT knowledge, they fall short in complex real-world scenarios requiring deep analysis of patients' cognitive structures and generating effective responses, suggesting potential future work.

Large language models (LLMs) hold great promise in summarizing medical evidence. Most recent studies focus on the application of proprietary LLMs. Using proprietary LLMs introduces multiple risk factors, including a lack of transparency and vendor dependency. While open-source LLMs allow better transparency and customization, their performance falls short compared to proprietary ones. In this study, we investigated to what extent fine-tuning open-source LLMs can further improve their performance in summarizing medical evidence. Utilizing a benchmark dataset, MedReview, consisting of 8,161 pairs of systematic reviews and summaries, we fine-tuned three broadly-used, open-sourced LLMs, namely PRIMERA, LongT5, and Llama-2. Overall, the fine-tuned LLMs obtained an increase of 9.89 in ROUGE-L (95% confidence interval: 8.94-10.81), 13.21 in METEOR score (95% confidence interval: 12.05-14.37), and 15.82 in CHRF score (95% confidence interval: 13.89-16.44). The performance of fine-tuned LongT5 is close to GPT-3.5 with zero-shot settings. Furthermore, smaller fine-tuned models sometimes even demonstrated superior performance compared to larger zero-shot models. The above trends of improvement were also manifested in both human and GPT4-simulated evaluations. Our results can be applied to guide model selection for tasks demanding particular domain knowledge, such as medical evidence summarization.

Large Language Models (LLMs) have acquired ubiquitous attention for their performances across diverse domains. Our study here searches through LLMs' cognitive abilities and confidence dynamics. We dive deep into understanding the alignment between their self-assessed confidence and actual performance. We exploit these models with diverse sets of questionnaires and real-world scenarios and extract how LLMs exhibit confidence in their responses. Our findings reveal intriguing instances where models demonstrate high confidence even when they answer incorrectly. This is reminiscent of the Dunning-Kruger effect observed in human psychology. In contrast, there are cases where models exhibit low confidence with correct answers revealing potential underestimation biases. Our results underscore the need for a deeper understanding of their cognitive processes. By examining the nuances of LLMs' self-assessment mechanism, this investigation provides noteworthy revelations that serve to advance the functionalities and broaden the potential applications of these formidable language models.