new

Get trending papers in your email inbox!

Subscribe

Daily Papers

byAK and the research community

Jul 21

The Impact of Medication Non-adherence on Adverse Outcomes: Evidence from Schizophrenia Patients via Survival Analysis

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

Mechanical Enforcement for LLM Governance:Evidence of Governance-Task Decoupling in Financial Decision Systems

Large language models in regulated financial workflows are governed by natural-language policies that the same model interprets, creating a principal--agent failure: outputs can appear compliant without being compliant. Existing evaluation measures task accuracy but not whether governance constrains behaviour at the decision rationale level -- where regulated decisions must be auditable. We introduce five governance metrics that quantify policy compliance at the rationale level and apply them in a synthetic banking domain to compare text-only governance against mechanical enforcement: four primitives operating outside the model's interpretive loop. Under text-only governance, 27% of deferrals carry no decision-relevant information. Mechanical enforcement reduces this rate by 73%, more than doubles deferral information content, and raises task accuracy from MCC~0.43 to 0.88. The improvement is driven by architectural separation: LLM-generated rationales under mechanical enforcement show comparable CDL to text-only governance -- the gain comes from removing clear-cut decisions from the model's control. A causal ablation confirms that each primitive is individually necessary. Our central finding is a governance-task decoupling: under structural stress, text-only governance degrades on both dimensions simultaneously, whereas mechanical enforcement preserves governance quality even as task performance drops. This implies that governance and task evaluation are distinct axes: accuracy is not a sufficient proxy for governance in regulated AI systems.

  • 2 authors
·
May 13

Safety and accuracy follow different scaling laws in clinical large language models

Clinical LLMs are often scaled by increasing model size, context length, retrieval complexity, or inference-time compute, with the implicit expectation that higher accuracy implies safer behavior. This assumption is incomplete in medicine, where a few confident, high-risk, or evidence-contradicting errors can matter more than average benchmark performance. We introduce SaFE-Scale, a framework for measuring how clinical LLM safety changes across model scale, evidence quality, retrieval strategy, context exposure, and inference-time compute. To instantiate this framework, we introduce RadSaFE-200, a Radiology Safety-Focused Evaluation benchmark of 200 multiple-choice questions with clinician-defined clean evidence, conflict evidence, and option-level labels for high-risk error, unsafe answer, and evidence contradiction. We evaluated 34 locally deployed LLMs across six deployment conditions: closed-book prompting (zero-shot), clean evidence, conflict evidence, standard RAG, agentic RAG, and max-context prompting. Clean evidence produced the strongest improvement, increasing mean accuracy from 73.5% to 94.1%, while reducing high-risk error from 12.0% to 2.6%, contradiction from 12.7% to 2.3%, and dangerous overconfidence from 8.0% to 1.6%. Standard RAG and agentic RAG did not reproduce this safety profile: agentic RAG improved accuracy over standard RAG and reduced contradiction, but high-risk error and dangerous overconfidence remained elevated. Max-context prompting increased latency without closing the safety gap, and additional inference-time compute produced only limited gains. Worst-case analysis showed that clinically consequential errors concentrated in a small subset of questions. Clinical LLM safety is therefore not a passive consequence of scaling, but a deployment property shaped by evidence quality, retrieval design, context construction, and collective failure behavior.

  • 12 authors
·
May 4

ScientistOne: Towards Human-Level Autonomous Research via Chain-of-Evidence

Autonomous research agents produce competitive solutions and professional-looking manuscripts, yet their outputs contain verifiability failures undetectable by surface-level evaluation: fabricated citations, unreproducible scores, and method descriptions that diverge from the implementation. We address this through three contributions. First, Chain-of-Evidence (CoE), a verifiability framework requiring every claim to be traceable to its evidence source. Second, ScientistOne, an end-to-end autonomous research system that maintains evidence chains by construction throughout literature review, solution discovery, and paper writing. Third, CoE Audit, a post-hoc audit whose four integrity checks -- score verification, specification violation, reference verification, and method-code alignment -- apply uniformly to all systems. Across 75 papers spanning five systems and five frontier research tasks, every baseline exhibits at least one systematic failure mode: hallucinated reference rates reach 21%, score verification passes in as few as 42% of papers, and method-code alignment ranges from 20% to 80%. ScientistOne achieves zero hallucinated references (0/337), perfect score verification (12/12), and the highest method-code alignment (14/15), while matching or exceeding human expert performance on all five tasks. ScientistOne further generalizes to six additional tasks spanning medical imaging, fine-grained recognition, 3D perception, and language modeling, achieving state-of-the-art on Parameter Golf and gold medals on MLE-Bench tasks where baselines fail entirely.

google Google
·
May 24 2

Reason Less, Verify More: Deterministic Gates Recover a Silent Policy-Violation Failure Mode in Tool-Using LLM Agents

Tool-using LLM agents can violate the very policies they are deployed to enforce while appearing to complete the task successfully. In policy-permissive environments, a tool may execute any well-formed call even when the corresponding state transition is forbidden by domain policy. The result is a silent wrong state (a booking cancelled, a passenger count changed, a claim acted on without verification) that neither the tool nor the agent's self-report exposes. We study this failure mode in the τ^2-bench airline domain. On a budget agent, 78% of observed failures are silent wrong-state failures with no tool error, and the aggregate failure rate is reproducible across disjoint seeds, not sampling noise. We then evaluate a lightweight intervention: deterministic, read-only pre-execution gates that inspect the proposed call and current state before allowing a write. A four-gate suite raises full-benchmark success from 29.6% to 42.0% on gpt-4o-mini (+12.4pp; paired task-level bootstrap P=0.0012), and the lift reproduces on a disjoint 15-seed set (+12.3pp; P=0.0008). The effect is concentrated where the gates fire: on the 26/50 firing tasks, success rises by +19.2pp, while movement on the 24 non-firing tasks does not exclude zero. Two negative controls (a self-enforcing retail domain and BFCL) bound the mechanism: gates help when tools are policy-permissive and add little where tools already self-enforce. As suggestive evidence, not a central claim, the same failure mode persists at the frontier: gpt-5.2 at default reasoning still attempts policy-violating writes, and the same suite improves success from 61.2% to 71.6% (+10.4pp; P=0.020; n=5, no replication). The contribution is a bounded evaluation and reliability result: deterministic gates do not guarantee task success, but they can deterministically prevent a known class of silent policy-violating writes at the action boundary.

  • 3 authors
·
Jul 7

Case-Grounded Evidence Verification: A Framework for Constructing Evidence-Sensitive Supervision

Evidence-grounded reasoning requires more than attaching retrieved text to a prediction: a model should make decisions that depend on whether the provided evidence supports the target claim. In practice, this often fails because supervision is weak, evidence is only loosely tied to the claim, and evaluation does not test evidence dependence directly. We introduce case-grounded evidence verification, a general framework in which a model receives a local case context, external evidence, and a structured claim, and must decide whether the evidence supports the claim for that case. Our key contribution is a supervision construction procedure that generates explicit support examples together with semantically controlled non-support examples, including counterfactual wrong-state and topic-related negatives, without manual evidence annotation. We instantiate the framework in radiology and train a standard verifier on the resulting support task. The learned verifier substantially outperforms both case-only and evidence-only baselines, remains strong under correct evidence, and collapses when evidence is removed or swapped, indicating genuine evidence dependence. This behavior transfers across unseen evidence articles and an external case distribution, though performance degrades under evidence-source shift and remains sensitive to backbone choice. Overall, the results suggest that a major bottleneck in evidence grounding is not only model capacity, but the lack of supervision that encodes the causal role of evidence.

  • 5 authors
·
Apr 9

Evidence Sufficiency Under Delayed Ground Truth: Proxy Monitoring for Risk Decision Systems

Machine learning systems in fraud detection, credit scoring, and clinical risk assessment operate under delayed ground truth: outcome labels arrive days to months after the decision they evaluate. During this blind period, governance evidence degrades through mechanisms that neither drift detection methods nor governance frameworks adequately address. This paper formalizes an evidence sufficiency model with four dimensions (completeness, freshness, reliability, representativeness) and a decision-readiness gate that quantifies how label latency degrades evidence quality. The model maps three drift types to dimension-specific degradation trajectories. A complementary proxy indicator framework comprising seven measurement categories estimates sufficiency degradation without labels, with explicit coverage mapping and characterized blind spots per drift type. Evaluation on the IEEE-CIS Fraud Detection dataset (~590K transactions) with controlled drift injection shows that composite proxy monitoring detects covariate and mixed drift with 100% detection rate, while concept drift without feature change remains undetected -- consistent with the theoretical impossibility of unsupervised detection when P(X) is unchanged. Blind period simulation confirms monotone sufficiency degradation, with concept drift degrading fastest (S=0.242 at day 60 vs 0.418 for no-drift). The framework contributes a governance sufficiency monitoring instrument; its value lies in translating drift signals into auditable sufficiency assessments with characterized blind spots. Mapping sufficiency levels to governance actions requires deployment-specific calibration beyond this study's scope.

  • 1 authors
·
Apr 16

Evidence Inference 2.0: More Data, Better Models

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

  • 5 authors
·
May 8, 2020

ReasonIF: Large Reasoning Models Fail to Follow Instructions During Reasoning

The ability of large language models (LLMs) to follow user instructions is central to their reliability, safety, and usefulness. While prior studies assess instruction adherence in the model's main responses, we argue that it is also critical for large reasoning models (LRMs) to follow user instructions throughout their reasoning process. Reasoning instruction following makes LRMs more controllable and transparent, while reducing risks of undesirable shortcuts, hallucinations, or reward hacking within reasoning traces. To evaluate this dimension, we introduce ReasonIF, a systematic benchmark for assessing reasoning instruction following. ReasonIF includes six categories of instruction prompts, spanning multilingual reasoning, formatting and length control. Across many open-source LRMs including GPT-OSS, Qwen3, and DeepSeek-R1, we find substantial failures in reasoning instruction adherence: the highest instruction following score (IFS) remains below 0.25, meaning that fewer than 25% of reasoning traces comply with the given instructions. Notably, as task difficulty increases, reasoning instruction following degrades further. We also explore two strategies to enhance reasoning instruction fidelity. (1) multi-turn reasoning and (2) Reasoning Instruction Finetuning (RIF) using synthetic data. RIF improves the IFS of GPT-OSS-20B from 0.11 to 0.27, indicating measurable progress but leaving ample room for improvement.

  • 5 authors
·
Oct 16, 2025

RFEval: Benchmarking Reasoning Faithfulness under Counterfactual Reasoning Intervention in Large Reasoning Models

Large Reasoning Models (LRMs) exhibit strong performance, yet often produce rationales that sound plausible but fail to reflect their true decision process, undermining reliability and trust. We introduce a formal framework for reasoning faithfulness, defined by two testable conditions: stance consistency (a coherent stance linking reasoning to answer) and causal influence (the stated reasoning causally drives the answer under output-level interventions), explicitly decoupled from accuracy. To operationalize this, we present RFEval, a benchmark of 7,186 instances across seven tasks that probes faithfulness via controlled, output-level counterfactual interventions. Evaluating twelve open-source LRMs, we find unfaithfulness in 49.7% of outputs, predominantly from stance inconsistency. Failures are concentrated in brittle, convergent domains such as math and code, and correlate more with post-training regimes than with scale: within-family ablations indicate that adding current RL-style objectives on top of supervised fine-tuning can reduce reasoning faithfulness, even when accuracy is maintained. Crucially, accuracy is neither a sufficient nor a reliable proxy for faithfulness: once controlling for model and task, the accuracy-faithfulness link is weak and statistically insignificant. Our work establishes a rigorous methodology for auditing LRM reliability and shows that trustworthy AI requires optimizing not only for correct outcomes but also for the structural integrity of the reasoning process. Our code and dataset can be found at project page: https://aidaslab.github.io/RFEval/}{https://aidaslab.github.io/RFEval/

  • 3 authors
·
Feb 18

AIMI: Leveraging Future Knowledge and Personalization in Sparse Event Forecasting for Treatment Adherence

Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.

  • 3 authors
·
Mar 20, 2025 2

Zero-shot reasoning for simulating scholarly peer-review

The scholarly publishing ecosystem faces a dual crisis of unmanageable submission volumes and unregulated AI, creating an urgent need for new governance models to safeguard scientific integrity. The traditional human-only peer review regime lacks a scalable, objective benchmark, making editorial processes opaque and difficult to audit. Here we investigate a deterministic simulation framework that provides the first stable, evidence-based standard for evaluating AI-generated peer review reports. Analyzing 352 peer-review simulation reports, we identify consistent system state indicators that demonstrate its reliability. First, the system is able to simulate calibrated editorial judgment, with 'Revise' decisions consistently forming the majority outcome (>50%) across all disciplines, while 'Reject' rates dynamically adapt to field-specific norms, rising to 45% in Health Sciences. Second, it maintains unwavering procedural integrity, enforcing a stable 29% evidence-anchoring compliance rate that remains invariant across diverse review tasks and scientific domains. These findings demonstrate a system that is predictably rule-bound, mitigating the stochasticity of generative AI. For the scientific community, this provides a transparent tool to ensure fairness; for publishing strategists, it offers a scalable instrument for auditing workflows, managing integrity risks, and implementing evidence-based governance. The framework repositions AI as an essential component of institutional accountability, providing the critical infrastructure to maintain trust in scholarly communication.

  • 1 authors
·
Oct 2, 2025

CiteVQA: Benchmarking Evidence Attribution for Trustworthy Document Intelligence

Multimodal Large Language Models (MLLMs) have significantly advanced document understanding, yet current Doc-VQA evaluations score only the final answer and leave the supporting evidence unchecked. This answer-only approach masks a critical failure mode: a model can land on the correct answer while grounding it in the wrong passage -- a critical risk in high-stakes domains like law, finance, and medicine, where every conclusion must be traceable to a specific source region. To address this, we introduce CiteVQA, a benchmark that requires models to return element-level bounding-box citations alongside each answer, evaluating both jointly. CiteVQA comprises 1,897 questions across 711 PDFs spanning seven domains and two languages, averaging 40.6 pages per document. To ensure fidelity and scalability, the ground-truth citations are generated by an automated pipeline-which identifies crucial evidence via masking ablation-and are subsequently validated through expert review. At the core of our evaluation is Strict Attributed Accuracy (SAA), which credits a prediction only when the answer and the cited region are both correct. Auditing 20 MLLMs reveals a pervasive Attribution Hallucination: models frequently produce the right answer while citing the wrong region. The strongest system (Gemini-3.1-Pro-Preview) achieves an SAA of only 76.0, and the strongest open-source MLLM reaches just 22.5. Ultimately, towards trustworthy document intelligence, CiteVQA exposes a reliability gap that answer-only evaluations overlook, providing the instrumentation needed to close it. Our repository is available at https://github.com/opendatalab/CiteVQA.

opendatalab OpenDataLab
·
May 12 3

Can LLM Agents Generate Real-World Evidence? Evaluating Observational Studies in Medical Databases

Observational studies can yield clinically actionable evidence at scale, but executing them on real-world databases is open-ended and requires coherent decisions across cohort construction, analysis, and reporting. Prior evaluations of LLM agents emphasize isolated steps or single answers, missing the integrity and internal structure of the resulting evidence bundle. To address this gap, we introduce RWE-bench, a benchmark grounded in MIMIC-IV and derived from peer-reviewed observational studies. Each task provides the corresponding study protocol as the reference standard, requiring agents to execute experiments in a real database and iteratively generate tree-structured evidence bundles. We evaluate six LLMs (three open-source, three closed-source) under three agent scaffolds using both question-level correctness and end-to-end task metrics. Across 162 tasks, task success is low: the best agent reaches 39.9%, and the best open-source model reaches 30.4%. Agent scaffolds also matter substantially, causing over 30% variation in performance metrics. Furthermore, we implement an automated cohort evaluation method to rapidly localize errors and identify agent failure modes. Overall, the results highlight persistent limitations in agents' ability to produce end-to-end evidence bundles, and efficient validation remains an important direction for future work. Code and data are available at https://github.com/somewordstoolate/RWE-bench.

  • 5 authors
·
Mar 23

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

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

intuit Intuit
·
Apr 6 2

Enhancing Large Language Models with Domain-specific Retrieval Augment Generation: A Case Study on Long-form Consumer Health Question Answering in Ophthalmology

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

  • 22 authors
·
Sep 20, 2024

Reward Design for Justifiable Sequential Decision-Making

Equipping agents with the capacity to justify made decisions using supporting evidence represents a cornerstone of accountable decision-making. Furthermore, ensuring that justifications are in line with human expectations and societal norms is vital, especially in high-stakes situations such as healthcare. In this work, we propose the use of a debate-based reward model for reinforcement learning agents, where the outcome of a zero-sum debate game quantifies the justifiability of a decision in a particular state. This reward model is then used to train a justifiable policy, whose decisions can be more easily corroborated with supporting evidence. In the debate game, two argumentative agents take turns providing supporting evidence for two competing decisions. Given the proposed evidence, a proxy of a human judge evaluates which decision is better justified. We demonstrate the potential of our approach in learning policies for prescribing and justifying treatment decisions of septic patients. We show that augmenting the reward with the feedback signal generated by the debate-based reward model yields policies highly favored by the judge when compared to the policy obtained solely from the environment rewards, while hardly sacrificing any performance. Moreover, in terms of the overall performance and justifiability of trained policies, the debate-based feedback is comparable to the feedback obtained from an ideal judge proxy that evaluates decisions using the full information encoded in the state. This suggests that the debate game outputs key information contained in states that is most relevant for evaluating decisions, which in turn substantiates the practicality of combining our approach with human-in-the-loop evaluations. Lastly, we showcase that agents trained via multi-agent debate learn to propose evidence that is resilient to refutations and closely aligns with human preferences.

  • 2 authors
·
Feb 24, 2024

When Cases Get Rare: A Retrieval Benchmark for Off-Guideline Clinical Question Answering

Across medical specialties, clinical practice is anchored in evidence-based guidelines that codify best studied diagnostic and treatment pathways. These pathways routinely fall short for the long tail of real-world care not covered by guidelines. Most medical large language models (LLMs), however, are trained to encode common, guideline-focused medical knowledge in their parameters. Current evaluations test models primarily on recalling and reasoning with this memorized content, often in multiple-choice settings. Given the fundamental importance of evidence-based reasoning in medicine, it is neither feasible nor reliable to depend on memorization in practice. To address this gap, we introduce OGCaReBench, a free-form retrieval-focused benchmark aimed at evaluating LLMs at answering clinical questions that require going beyond typical guidelines. Extracted from published medical case reports and validated by medical experts, OGCaReBench contains long-form clinical questions requiring free-text answers, providing a systematic framework for assessing open-ended medical reasoning in rare, case-based scenarios. Our experiments reveal that even the best-performing baseline (GPT-5.2) correctly answers only 56% of our benchmark with specialized models only reaching 42%. Augmenting models with retrieved medical articles improves this performance to up to 82% (using GPT-5.2) highlighting the importance of evidence-grounding for real-world medical reasoning tasks. This work thus establishes a foundation for benchmarking and advancing both general-purpose and medical LLMs to produce reliable answers in challenging clinical contexts.

  • 14 authors
·
May 19

Does Inference Scaling Improve Reasoning Faithfulness? A Multi-Model Analysis of Self-Consistency Tradeoffs

Self-consistency has emerged as a popular technique for improving large language model accuracy on reasoning tasks. The approach is straightforward: generate multiple reasoning paths and select the most common answer through majority voting. While this reliably boosts accuracy, it remains unclear whether these gains reflect genuine improvements in reasoning quality. We investigate a fundamental question that has not been studied before: does inference scaling improve reasoning faithfulness? We conduct a comprehensive empirical study across four frontier models (GPT-5.2, Claude Opus 4.5, Gemini-3-flash-preview, and DeepSeek-v3.2) on 100 GSM8K mathematical reasoning problems. Our analysis employs bootstrap confidence intervals, McNemar's tests for paired comparisons, and Cohen's d effect sizes to quantify the effects rigorously. The results reveal striking differences across models that challenge common assumptions about self-consistency. GPT-5.2 shows the expected pattern: accuracy improves from 78% to 90% at N=5, with faithfulness remaining relatively stable (0.540 to 0.510). Claude Opus 4.5 tells a completely different story. Its accuracy actually drops from 78% to 74.3% while faithfulness jumps dramatically from 0.270 to 0.891 at N=5. DeepSeek-v3.2, already at 98% accuracy, shows ceiling effects with modest faithfulness gains (0.440 to 0.541). Gemini-3-flash improves from 81% to 86% accuracy with a slight faithfulness decrease (0.260 to 0.212). Problem difficulty analysis reveals that GPT-5.2 solves 82% of hard problems while breaking only 13% of easy ones. Claude, in contrast, breaks 23% of easy problems, explaining its accuracy decrease. These findings matter for practitioners: self-consistency is not universally beneficial, and teams should test their specific models before deployment. We release our code and provide practical recommendations for navigating these tradeoffs.

  • 1 authors
·
Jan 9 2

Understanding and Mitigating Premature Confidence for Better LLM Reasoning

Long chains of thought (CoT) from current language models frequently contain logical gaps and unjustified leaps, limiting the gains from additional test-time compute. Improving reasoning quality directly would require process reward models, but the step-level annotations needed to train them are expensive and scarce. We find such a signal in how the model's confidence evolves during reasoning: premature confidence, the tendency to commit to an answer early and use the remaining tokens to rationalize it, strongly predicts flawed reasoning across tasks and model scales. We exploit this in progressive confidence shaping, a reinforcement learning objective that trains models to update their confidence as they reason rather than commit early -- rewarding gradual confidence growth and penalizing early commitment, with no external labels or reward models. The method improves accuracy and reasoning quality from 1.5B to 8B parameters across arithmetic (Countdown), math (DAPO, AIME), and science (ScienceQA): on Countdown, accuracy improves 3.2x (+42.0pp) and flawed reasoning drops 48pp; on AIME, Pass@64 improves 6.6pp. Consistent with this mechanism, the method also improves faithfulness: on a safety benchmark, our models more transparently surface misleading content in their reasoning traces rather than concealing it. Controlled experiments reveal that the problem and its remedy scale together: premature confidence grows with model size and task difficulty, and so do the gains from addressing it.

  • 7 authors
·
May 22

AI scientists produce results without reasoning scientifically

Large language model (LLM)-based systems are increasingly deployed to conduct scientific research autonomously, yet whether their reasoning adheres to the epistemic norms that make scientific inquiry self-correcting is poorly understood. Here, we evaluate LLM-based scientific agents across eight domains, spanning workflow execution to hypothesis-driven inquiry, through more than 25,000 agent runs and two complementary lenses: (i) a systematic performance analysis that decomposes the contributions of the base model and the agent scaffold, and (ii) a behavioral analysis of the epistemological structure of agent reasoning. We observe that the base model is the primary determinant of both performance and behavior, accounting for 41.4% of explained variance versus 1.5% for the scaffold. Across all configurations, evidence is ignored in 68% of traces, refutation-driven belief revision occurs in 26%, and convergent multi-test evidence is rare. The same reasoning pattern appears whether the agent executes a computational workflow or conducts hypothesis-driven inquiry. They persist even when agents receive near-complete successful reasoning trajectories as context, and the resulting unreliability compounds across repeated trials in epistemically demanding domains. Thus, current LLM-based agents execute scientific workflows but do not exhibit the epistemic patterns that characterize scientific reasoning. Outcome-based evaluation cannot detect these failures, and scaffold engineering alone cannot repair them. Until reasoning itself becomes a training target, the scientific knowledge produced by such agents cannot be justified by the process that generated it.

SemEval-2023 Task 7: Multi-Evidence Natural Language Inference for Clinical Trial Data

This paper describes the results of SemEval 2023 task 7 -- Multi-Evidence Natural Language Inference for Clinical Trial Data (NLI4CT) -- consisting of 2 tasks, a Natural Language Inference (NLI) task, and an evidence selection task on clinical trial data. The proposed challenges require multi-hop biomedical and numerical reasoning, which are of significant importance to the development of systems capable of large-scale interpretation and retrieval of medical evidence, to provide personalized evidence-based care. Task 1, the entailment task, received 643 submissions from 40 participants, and Task 2, the evidence selection task, received 364 submissions from 23 participants. The tasks are challenging, with the majority of submitted systems failing to significantly outperform the majority class baseline on the entailment task, and we observe significantly better performance on the evidence selection task than on the entailment task. Increasing the number of model parameters leads to a direct increase in performance, far more significant than the effect of biomedical pre-training. Future works could explore the limitations of large models for generalization and numerical inference, and investigate methods to augment clinical datasets to allow for more rigorous testing and to facilitate fine-tuning. We envisage that the dataset, models, and results of this task will be useful to the biomedical NLI and evidence retrieval communities. The dataset, competition leaderboard, and website are publicly available.

  • 6 authors
·
May 4, 2023

ReportLogic: Evaluating Logical Quality in Deep Research Reports

Users increasingly rely on Large Language Models (LLMs) for Deep Research, using them to synthesize diverse sources into structured reports that support understanding and action. In this context, the practical reliability of such reports hinges on logical quality: whether the report's claims and arguments are explicitly supported and can be trusted as a basis for downstream use, rather than merely appearing fluent or informative. However, current evaluation frameworks largely overlook this requirement. To bridge this gap, we introduce ReportLogic, a benchmark that quantifies report-level logical quality through a reader-centric lens of auditability. Specifically, ReportLogic adopts a hierarchical taxonomy that evaluates whether readers can (1) trace an on-topic report structure with a unified analytical arc (Macro-Logic), (2) understand the progression with necessary context (Expositional-Logic), and (3) verify conclusions via explicit claim--support (Structural-Logic). Based on this taxonomy, we construct a human-annotated rubric-guided dataset and train an open-source LogicJudge for scalable evaluation. We further evaluate judge robustness via adversarial attacks, showing that off-the-shelf LLM judges are frequently influenced by superficial cues (e.g., verbosity), and reasoning modes can mask broken support relations. Overall, our results provide actionable guidance for building more robust logic evaluators and improving the logical reliability of LLM-generated reports.

  • 7 authors
·
Jan 27

Parrot: Persuasion and Agreement Robustness Rating of Output Truth -- A Sycophancy Robustness Benchmark for LLMs

This study presents PARROT (Persuasion and Agreement Robustness Rating of Output Truth), a robustness focused framework designed to measure the degradation in accuracy that occurs under social pressure exerted on users through authority and persuasion in large language models (LLMs) the phenomenon of sycophancy (excessive conformity). PARROT (i) isolates causal effects by comparing the neutral version of the same question with an authoritatively false version using a double-blind evaluation, (ii) quantifies confidence shifts toward the correct and imposed false responses using log-likelihood-based calibration tracking, and (iii) systematically classifies failure modes (e.g., robust correct, sycophantic agreement, reinforced error, stubborn error, self-correction, etc.) using an eight-state behavioral taxonomy. We evaluated 22 models using 1,302 MMLU-style multiple-choice questions across 13 domains and domain-specific authority templates. Findings show marked heterogeneity: advanced models (e.g., GPT-5, GPT-4.1, Claude Sonnet 4.5) exhibit low "follow rates" (leq 11%, GPT-5: 4\%) and minimal accuracy loss, while older/smaller models show severe epistemic collapse (GPT-4: 80\%, Qwen 2.5-1.5B: 94\%). The danger is not limited to response changes; weak models reduce confidence in the correct response while increasing confidence in the imposed incorrect response. While international law and global knowledge at the domain level exhibit high fragility, elementary mathematics is relatively resilient. Consequently, we argue that the goal of "resistance to overfitting pressure" should be addressed as a primary objective alongside accuracy, harm avoidance, and privacy for safe deployment in the real world.

  • 3 authors
·
Nov 21, 2025 4

Lie to Me: How Faithful Is Chain-of-Thought Reasoning in Reasoning Models?

Chain-of-thought (CoT) reasoning has been proposed as a transparency mechanism for large language models in safety-critical deployments, yet its effectiveness depends on faithfulness (whether models accurately verbalize the factors that actually influence their outputs), a property that prior evaluations have examined in only two proprietary models, finding acknowledgment rates as low as 25% for Claude 3.7 Sonnet and 39% for DeepSeek-R1. To extend this evaluation across the open-weight ecosystem, this study tests 12 open-weight reasoning models spanning 9 architectural families (7B-685B parameters) on 498 multiple-choice questions from MMLU and GPQA Diamond, injecting six categories of reasoning hints (sycophancy, consistency, visual pattern, metadata, grader hacking, and unethical information) and measuring the rate at which models acknowledge hint influence in their CoT when hints successfully alter answers. Across 41,832 inference runs, overall faithfulness rates range from 39.7% (Seed-1.6-Flash) to 89.9% (DeepSeek-V3.2-Speciale) across model families, with consistency hints (35.5%) and sycophancy hints (53.9%) exhibiting the lowest acknowledgment rates. Training methodology and model family predict faithfulness more strongly than parameter count, and keyword-based analysis reveals a striking gap between thinking-token acknowledgment (approximately 87.5%) and answer-text acknowledgment (approximately 28.6%), suggesting that models internally recognize hint influence but systematically suppress this acknowledgment in their outputs. These findings carry direct implications for the viability of CoT monitoring as a safety mechanism and suggest that faithfulness is not a fixed property of reasoning models but varies systematically with architecture, training method, and the nature of the influencing cue.

  • 1 authors
·
Mar 23 2

Quantifying Consistency in LLM Logical Reasoning via Structural Uncertainty

Large language models can arrive at the same answer through reasoning paths that are unstable, contradictory, or difficult to rank consistently -- a failure mode especially prevalent in multi-step deductive reasoning. Existing methods assess reliability primarily through output dispersion -- measuring how much sampled answers differ -- but this discards a complementary signal: whether the model can consistently rank competing reasoning candidates. We propose structural uncertainty, a consistency-aware framework derived from the stability of self-preference-induced rankings over sampled reasoning solutions. Given a query, we generate multiple candidate solutions and ask the model to judge pairwise preferences among its own outputs. We aggregate self-preferences into ranking distributions via Bradley-Terry modeling with PageRank, and decompose the signal into two entropy-based components: across-trial ranking instability and within-trial candidate ambiguity. Across five LLMs and eight benchmarks, structural signals provide information complementary to answer dispersion: on logical and mathematical reasoning tasks, the combination improves identification of unreliable instances, while on factual retrieval the structural signal collapses toward uniformity, diagnosing a regime boundary where reasoning-level consistency evaluation is uninformative. The two components relate differently to accuracy: within-trial ambiguity correlates positively with correctness -- consistent with settings where multiple plausible solution paths remain competitive -- while across-trial instability correlates negatively, signaling unreliable reasoning. Structural uncertainty is best understood not as a universal confidence estimator, but as a regime-sensitive evaluator of logical reasoning consistency.

  • 6 authors
·
Jun 14

The Last Word Often Wins: A Format Confound in Chain-of-Thought Corruption Studies

Corruption studies, the primary tool for evaluating chain-of-thought (CoT) faithfulness, identify which chain positions are "computationally important" by measuring accuracy when steps are replaced with errors. We identify a systematic confound: for chains with explicit terminal answer statements, the dominant format in standard benchmarks, corruption studies detect where the answer text appears, not where computation occurs. A within-dataset format ablation provides the key evidence: on standard GSM8K chains ending with "the answer is X," removing only the answer statement, preserving all reasoning, collapses suffix sensitivity ~19x at 3B (N=300, p=0.022). Conflicting-answer experiments quantify the causal mechanism: at 7B, CC accuracy drops to near-zero (<=0.02) across five architecture families; the followed-wrong rate spans 0.63-1.00 at 3B-7B and attenuates at larger scales (0.300 at Phi-4-14B, ~0.01 at 32B). A within-stable 7B replication (9.3x attenuation, N=76, p=7.8e-3; Qwen3-8B N=299, p=0.004) provides converging evidence, and the pattern replicates on MATH (DeepSeek-R1-7B: 10.9x suffix-survival recovery). On chains without answer suffixes the same protocol identifies the prefix as load-bearing (Delta=-0.77, p<10^-12). Generation-time probes confirm a dissociation: the answer is not early-determined during generation (early commitment <5%), yet at consumption time model outputs systematically follow the explicit answer text. The format-determination effect persists through 14B (8.5x ratio, p=0.001) and converges toward zero at 32B. We propose a three-prerequisite protocol (question-only control, format characterization, all-position sweep) as a minimum standard for corruption-based faithfulness studies.

  • 1 authors
·
May 10

Rethinking Retrieval-Augmented Generation for Medicine: A Large-Scale, Systematic Expert Evaluation and Practical Insights

Large language models (LLMs) are transforming the landscape of medicine, yet two fundamental challenges persist: keeping up with rapidly evolving medical knowledge and providing verifiable, evidence-grounded reasoning. Retrieval-augmented generation (RAG) has been widely adopted to address these limitations by supplementing model outputs with retrieved evidence. However, whether RAG reliably achieves these goals remains unclear. Here, we present the most comprehensive expert evaluation of RAG in medicine to date. Eighteen medical experts contributed a total of 80,502 annotations, assessing 800 model outputs generated by GPT-4o and Llama-3.1-8B across 200 real-world patient and USMLE-style queries. We systematically decomposed the RAG pipeline into three components: (i) evidence retrieval (relevance of retrieved passages), (ii) evidence selection (accuracy of evidence usage), and (iii) response generation (factuality and completeness of outputs). Contrary to expectation, standard RAG often degraded performance: only 22% of top-16 passages were relevant, evidence selection remained weak (precision 41-43%, recall 27-49%), and factuality and completeness dropped by up to 6% and 5%, respectively, compared with non-RAG variants. Retrieval and evidence selection remain key failure points for the model, contributing to the overall performance drop. We further show that simple yet effective strategies, including evidence filtering and query reformulation, substantially mitigate these issues, improving performance on MedMCQA and MedXpertQA by up to 12% and 8.2%, respectively. These findings call for re-examining RAG's role in medicine and highlight the importance of stage-aware evaluation and deliberate system design for reliable medical LLM applications.

  • 27 authors
·
Nov 10, 2025

Distortion Instead of Hallucination: The Effect of Reasoning Under Strict Constraints

With the widespread adoption of large language models (LLMs), hallucinations, which are non-factual fabrications in model outputs, have become serious concerns. Reasoning capabilities have received attention as a self-verification process to improve output reliability. However, the effect of reasoning within a closed system where LLMs cannot rely on external tools or knowledge has yet to be clarified. We therefore conduct experiments under strict constraints (recommending peer-reviewed journal articles in computer science) to examine the effect of reasoning across multiple models (GPT-5.2 and Gemini 3 Flash). Our results reveal a problematic trade-off between constraint compliance and factual accuracy. Non-reasoning models exhibit high constraint violation rates (66-75%) but maintain factual accuracy, while reasoning models reduce violations (13-26%) but systematically distort known facts to satisfy constraints and increase complete fabrication. This trade-off pattern is consistent across both models despite different architectures, indicating a fundamental limitation of reasoning. Furthermore, reasoning does not uniformly improve output authenticity: effects diverge by model, reflecting different allocations of the compliance-truthfulness trade-off. These findings challenge the assumption that reasoning universally improves reliability: reasoning models trade honest constraint violations for detection-resistant distortions.

  • 1 authors
·
Jan 4

Coding-agents can replicate scientific machine learning papers

Scientific machine learning papers typically make computational claims, e.g., that the relative mean square error is less than 5% or that the 95% predictive credible interval covers the test data. A coding agent can be prompted to replicate those claims from paper materials alone, but the prompt does not by itself reliably preserve progress or check whether generated evidence supports the paper's claims. We introduce Paper-replication, a workflow that makes each selected paper claim a target with recorded evidence, and implement it as a coding-agent skill. The workflow makes the agent record those targets, reconstruct the paper's method, run computational experiments, link generated outputs to provenance and comparisons with the paper's claims, record where matched evidence appears in the replication report, and pass validation checks before completion. We evaluate Paper-replication on twelve independent runs across four scientific machine learning papers. All twelve workspaces pass the completion gate, and all 158 recorded targets are matched with report coverage. Even in this completed workspace state, repeated runs differ in how papers are divided into targets, in numerical fidelity to the source papers, in elapsed replication time, in the number of intermediate executions replaced before final evidence is accepted, and in the rules used to accept evidence. Paper-replication makes completion depend on workspace evidence and validation checks rather than on the agent's final message.

  • 2 authors
·
Jul 9

Sibyl-AutoResearch: Autonomous Research Needs Self-Evolving Trial-and-Error Harnesses, Not Paper Generators

Autonomous research systems increasingly make the scientific workflow executable: agents can propose ideas, run code, inspect results, and draft papers. But executable workflows do not by themselves produce research judgment. We analyze where current systems lose trial experience: weak evidence becomes prose, pilot signals become broad claims, memory remains textual, and recurring process failures do not change later behavior. We introduce Sibyl-AutoResearch, a self-evolving AutoResearch framework built around Scientific Trial-and-Error Harnesses. A harness lets agents run bounded trials, preserve positive and negative outcomes, and route lessons into later planning, validation, claim scope, scheduling, critique, writing, and harness repair. We formalize this through two auditable conversion units: trial-to-behavior conversion, which links trial signals to later research actions, and trial-to-harness-behavior conversion, which links recurring process failures to system updates. We implement the framework in SIBYL, a file-backed autonomous research system that exposes the state, roles, memory, gates, and artifact traces needed to inspect these conversion paths. A retrospective audit identifies eight high-confidence conversion events, with a median latency of one iteration and a maximum latency of three iterations. A recovered-failure registry further shows how five naturally occurring failure classes, including duplicate results, stale numbers, and unsupported statistics, were blocked, downgraded, or routed into later repair. These traces do not establish a comparative performance claim; they show that the proposed conversion units are recoverable from realistic autonomous-research workspaces. The SIBYL framework and system are available at https://github.com/Sibyl-Research-Team/AutoResearch-SibylSystem.

  • 6 authors
·
May 20

FactReview: Evidence-Grounded Reviews with Literature Positioning and Execution-Based Claim Verification

Peer review in machine learning is under growing pressure from rising submission volume and limited reviewer time. Most LLM-based reviewing systems read only the manuscript and generate comments from the paper's own narrative. This makes their outputs sensitive to presentation quality and leaves them weak when the evidence needed for review lies in related work or released code. We present FactReview, an evidence-grounded reviewing system that combines claim extraction, literature positioning, and execution-based claim verification. Given a submission, FactReview identifies major claims and reported results, retrieves nearby work to clarify the paper's technical position, and, when code is available, executes the released repository under bounded budgets to test central empirical claims. It then produces a concise review and an evidence report that assigns each major claim one of five labels: Supported, Supported by the paper, Partially supported, In conflict, or Inconclusive. In a case study on CompGCN, FactReview reproduces results that closely match those reported for link prediction and node classification, yet also shows that the paper's broader performance claim across tasks is not fully sustained: on MUTAG graph classification, the reproduced result is 88.4%, whereas the strongest baseline reported in the paper remains 92.6%. The claim is therefore only partially supported. More broadly, this case suggests that AI is most useful in peer review not as a final decision-maker, but as a tool for gathering evidence and helping reviewers produce more evidence-grounded assessments. The code is public at https://github.com/DEFENSE-SEU/Review-Assistant.

MedMMV: A Controllable Multimodal Multi-Agent Framework for Reliable and Verifiable Clinical Reasoning

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

  • 7 authors
·
Sep 29, 2025

Coherence Under Commitment: Probing Generalization and Vacuous Memorization in LLM Logical Reasoning

Large language models (LLMs) deployed for logical reasoning in knowledge-intensive domains exhibit a subtle but critical failure: coherence can be vacuously achieved through systematic abstention. A model that withholds commitment to either entailment or refutation satisfies negation consistency while providing no utility. We introduce Coherence Under Commitment (CUC), a dual-query evaluation paradigm that jointly measures consistency and decisiveness. CUC contributes three innovations: (1) a commitment score c(φ) = p(φ) + p(lnotφ) quantifying probability mass allocated to decisive outcomes; (2) a deterministic elicitation protocol via normalized YES/NO log probabilities, eliminating sampling variance; and (3) a 3-way decision framework (True/False/Uncertain) operationalizing the coherence-commitment trade-off into metrics. Experiments on four open-weight LLMs (1B-3B) across 204 FOLIO examples expose a sharp frontier. Qwen2.5-3B achieves near-zero contradiction (E[v_{neg}]{=}0.025) but only 7.4% coverage, while TinyLlama-1.1B reaches 79.4% coverage with violations on every example. Coherence-only evaluation would rank the abstaining model first; CUC exposes this as vacuous, and the frontier generalizes to LogiQA~v2 (ρ{=}0.97). We argue that evaluation must report both coherence and non-vacuous commitment and release a toolkit for standardized assessment.

  • 2 authors
·
Jun 18

An AI agent for treatment reasoning over a biomedical tool universe

Treatment reasoning underpins every therapeutic decision, integrating disease context, comorbidities, medications, contraindications, and evolving biomedical knowledge to select an appropriate therapy. It is inherently iterative: candidates are weighed against many constraints, revised as evidence emerges, and grounded in verifiable sources. Here we introduce ATHENA-R1, an AI agent for treatment reasoning across all FDA approved drugs since 1939, trained by reinforcement learning over a universe of 212 biomedical tools. At each step it identifies missing information, selects and runs relevant tools, and incorporates the evidence. To train it without human-annotated traces, we build a two-level self-learning framework: multi-agent systems construct the tools, tasks, and reasoning trajectories for supervised fine-tuning, then reinforcement learning with scientific feedback rewards reasoning quality (evidence gathering, grounded tool use, logical non-redundancy). Across five benchmarks of 3,168 drug reasoning tasks and 456 patient treatment cases, ATHENA-R1 outperforms language models and tool-use systems, reaching 94.7% accuracy on open-ended drug reasoning and 82.9% on treatment reasoning, 17.8 and 10.7 points above GPT-5. In blinded evaluations by experts from 28 rare disease organizations, it is preferred over reference models on all criteria, and physicians rated it favorably on complex hospitalized cardiovascular and infectious-disease cases. Adverse-event hypotheses it generated, tested in electronic health records from 5.4 million patients, reached adjusted odds ratios of 1.48-1.84, with no elevation among negative controls. Because it requires knowing what evidence to seek before concluding, treatment reasoning has long been hard for AI; we show it can be reframed as a learnable process of iterative evidence gathering that reinforcement learning can train AI to perform.

  • 16 authors
·
Jun 26

VERITAS: A Multi-Agent Co-Scientist for Verifiable Image-Derived Hypothesis Testing

Scientific research based on multimodal clinical data (including medical imaging) requires coordinating clinical, radiological, programming, and biostatistical expertise, a fragmented process that bottlenecks discovery. We present VERITAS (Verifiable Epistemic Reasoning for Image-Derived Hypothesis Testing via Agentic Systems), a clinical co-scientist: a multi-agent system that autonomously tests natural-language hypotheses and produces a fully auditable evidence trail, tracing every conclusion through executable outputs from analysis plan to segmentation masks to statistical code to final verdict. Unlike prior AI-scientist systems, which mainly operate on tabular or text data, VERITAS grounds autonomous discovery directly in medical images. It decomposes the workflow into four phases handled by role-specialized agents, and introduces an epistemic evidence label framework that mechanically classifies outcomes as Supported, Refuted, Underpowered, or Invalid by jointly evaluating significance, effect direction, and study power. This distinction is critical in medical imaging, where non-significant results often reflect insufficient sample size rather than absent effects. We construct a tiered benchmark of 64 hypotheses spanning six complexity levels across cardiac and brain glioma MRI datasets. VERITAS reaches 81.4% verdict accuracy with frontier models and 71.2% with locally-hosted open-weight models (8-30B), outperforming all single-model baselines in both classes. It also produces the highest rate of independently verifiable statistical outputs (86.6%), so even its failures remain diagnosable through artifact inspection. Structured multi-agent decomposition thus substitutes for model scale while preserving the verifiability that scientific discovery demands. We release code, hypothesis bank, and evaluation pipeline at https://github.com/LucZot/veritas.

  • 3 authors
·
Jun 30

Multi-LLM Thematic Analysis with Dual Reliability Metrics: Combining Cohen's Kappa and Semantic Similarity for Qualitative Research Validation

Qualitative research faces a critical reliability challenge: traditional inter-rater agreement methods require multiple human coders, are time-intensive, and often yield moderate consistency. We present a multi-perspective validation framework for LLM-based thematic analysis that combines ensemble validation with dual reliability metrics: Cohen's Kappa (κ) for inter-rater agreement and cosine similarity for semantic consistency. Our framework enables configurable analysis parameters (1-6 seeds, temperature 0.0-2.0), supports custom prompt structures with variable substitution, and provides consensus theme extraction across any JSON format. As proof-of-concept, we evaluate three leading LLMs (Gemini 2.5 Pro, GPT-4o, Claude 3.5 Sonnet) on a psychedelic art therapy interview transcript, conducting six independent runs per model. Results demonstrate Gemini achieves highest reliability (κ= 0.907, cosine=95.3%), followed by GPT-4o (κ= 0.853, cosine=92.6%) and Claude (κ= 0.842, cosine=92.1%). All three models achieve a high agreement (κ> 0.80), validating the multi-run ensemble approach. The framework successfully extracts consensus themes across runs, with Gemini identifying 6 consensus themes (50-83% consistency), GPT-4o identifying 5 themes, and Claude 4 themes. Our open-source implementation provides researchers with transparent reliability metrics, flexible configuration, and structure-agnostic consensus extraction, establishing methodological foundations for reliable AI-assisted qualitative research.

YaleUniversity Yale University
·
Dec 23, 2025 2

Precision Is Not Faithfulness: Coverage-Aware Evaluation of Grounded Generation with a Complete Oracle

Reference-free faithfulness metrics verify each atomic claim a model makes against ground truth, and are increasingly used to evaluate grounded generation. We show they share a blind spot: they measure only precision -- are the stated claims supported? -- and therefore reward abstention, since a model can score near-perfect faithfulness by saying almost nothing. We make this measurable using Formula 1 telemetry, a domain where strategic ground truth is derived deterministically and, crucially, completely: for each decision we know the full set of facts that mattered. This completeness -- absent in open-domain faithfulness benchmarks -- lets us measure recall (coverage of the relevant facts) exactly, alongside precision. On a multilingual (EN/ES/PT) benchmark of 7,253 decision instances spanning 150 races, the most precise frontier model covers under half of the relevant facts and ranks last by F1, so requiring coverage reorders the systems; the same effect reappears in a second complete-oracle domain (NOAA weather forecasts). A prompt ablation shows the low coverage is not an under-prompting artifact: explicitly asking models to be thorough does not close the gap. We pair faithfulness with coverage into a single score, validate the metric (controlled perturbation; agreement across a model-free regex extractor and a cross-family LLM extractor, system-level Spearman 1.0), and give a verifier-guided generation method that improves precision and recall without references. We release the benchmark, structured annotations, metric, baselines, and an interactive demo.

  • 1 authors
·
Jun 7 6

CiteAudit: You Cited It, But Did You Read It? A Benchmark for Verifying Scientific References in the LLM Era

Scientific research relies on accurate citation for attribution and integrity, yet large language models (LLMs) introduce a new risk: fabricated references that appear plausible but correspond to no real publications. Such hallucinated citations have already been observed in submissions and accepted papers at major machine learning venues, exposing vulnerabilities in peer review. Meanwhile, rapidly growing reference lists make manual verification impractical, and existing automated tools remain fragile to noisy and heterogeneous citation formats and lack standardized evaluation. We present the first comprehensive benchmark and detection framework for hallucinated citations in scientific writing. Our multi-agent verification pipeline decomposes citation checking into claim extraction, evidence retrieval, passage matching, reasoning, and calibrated judgment to assess whether a cited source truly supports its claim. We construct a large-scale human-validated dataset across domains and define unified metrics for citation faithfulness and evidence alignment. Experiments with state-of-the-art LLMs reveal substantial citation errors and show that our framework significantly outperforms prior methods in both accuracy and interpretability. This work provides the first scalable infrastructure for auditing citations in the LLM era and practical tools to improve the trustworthiness of scientific references.

On Measuring Faithfulness or Self-consistency of Natural Language Explanations

Large language models (LLMs) can explain their predictions through post-hoc or Chain-of-Thought (CoT) explanations. But an LLM could make up reasonably sounding explanations that are unfaithful to its underlying reasoning. Recent work has designed tests that aim to judge the faithfulness of post-hoc or CoT explanations. In this work we argue that these faithfulness tests do not measure faithfulness to the models' inner workings -- but rather their self-consistency at output level. Our contributions are three-fold: i) We clarify the status of faithfulness tests in view of model explainability, characterising them as self-consistency tests instead. This assessment we underline by ii) constructing a Comparative Consistency Bank for self-consistency tests that for the first time compares existing tests on a common suite of 11 open LLMs and 5 tasks -- including iii) our new self-consistency measure CC-SHAP. CC-SHAP is a fine-grained measure (not a test) of LLM self-consistency. It compares how a model's input contributes to the predicted answer and to generating the explanation. Our fine-grained CC-SHAP metric allows us iii) to compare LLM behaviour when making predictions and to analyse the effect of other consistency tests at a deeper level, which takes us one step further towards measuring faithfulness by bringing us closer to the internals of the model than strictly surface output-oriented tests. Our code is available at https://github.com/Heidelberg-NLP/CC-SHAP

  • 2 authors
·
Nov 13, 2023

ClawArena: Benchmarking AI Agents in Evolving Information Environments

AI agents deployed as persistent assistants must maintain correct beliefs as their information environment evolves. In practice, evidence is scattered across heterogeneous sources that often contradict one another, new information can invalidate earlier conclusions, and user preferences surface through corrections rather than explicit instructions. Existing benchmarks largely assume static, single-authority settings and do not evaluate whether agents can keep up with this complexity. We introduce ClawArena, a benchmark for evaluating AI agents in evolving information environments. Each scenario maintains a complete hidden ground truth while exposing the agent only to noisy, partial, and sometimes contradictory traces across multi-channel sessions, workspace files, and staged updates. Evaluation is organized around three coupled challenges: multi-source conflict reasoning, dynamic belief revision, and implicit personalization, whose interactions yield a 14-category question taxonomy. Two question formats, multi-choice (set-selection) and shell-based executable checks, test both reasoning and workspace grounding. The current release contains 64 scenarios across 8 professional domains, totaling 1{,}879 evaluation rounds and 365 dynamic updates. Experiments on five agent frameworks and five language models show that both model capability (15.4% range) and framework design (9.2%) substantially affect performance, that self-evolving skill frameworks can partially close model-capability gaps, and that belief revision difficulty is determined by update design strategy rather than the mere presence of updates. Code is available at https://github.com/aiming-lab/ClawArena.

Consistency Amplifies: How Behavioral Variance Shapes Agent Accuracy

As LLM-based agents are deployed in production systems, understanding their behavioral consistency (whether they produce similar action sequences when given identical tasks) becomes critical for reliability. We study consistency in the context of SWE-bench, a challenging software engineering benchmark requiring complex, multi-step reasoning. Comparing Claude~4.5~Sonnet, GPT-5, and Llama-3.1-70B across 50 runs each (10 tasks times 5 runs), we find that across models, higher consistency aligns with higher accuracy: Claude achieves the lowest variance (CV: 15.2\%) and highest accuracy (58\%), GPT-5 is intermediate (CV: 32.2\%, accuracy: 32\%), and Llama shows the highest variance (CV: 47.0\%) with lowest accuracy (4\%). However, within a model, consistency can amplify both correct and incorrect interpretations. Our analysis reveals a critical nuance: consistency amplifies outcomes rather than guaranteeing correctness. 71\% of Claude's failures stem from "consistent wrong interpretation": making the same incorrect assumption across all runs. Interestingly, GPT-5 achieves similar early strategic agreement as Claude (diverging at step 3.4 vs.\ 3.2) but exhibits 2.1times higher variance, suggesting that divergence timing alone does not determine consistency. These findings suggest that for production deployment, interpretation accuracy matters more than execution consistency, with implications for agent evaluation and training.

Snowflake Snowflake
·
Mar 25 2

Agentic retrieval-augmented reasoning reshapes collective reliability under model variability in radiology question answering

Agentic retrieval-augmented reasoning pipelines are increasingly used to structure how large language models (LLMs) incorporate external evidence in clinical decision support. These systems iteratively retrieve curated domain knowledge and synthesize it into structured reports before answer selection. Although such pipelines can improve performance, their impact on reliability under model variability remains unclear. In real-world deployment, heterogeneous models may align, diverge, or synchronize errors in ways not captured by accuracy. We evaluated 34 LLMs on 169 expert-curated publicly available radiology questions, comparing zero-shot inference with a radiology-specific multi-step agentic retrieval condition in which all models received identical structured evidence reports derived from curated radiology knowledge. Agentic inference reduced inter-model decision dispersion (median entropy 0.48 vs. 0.13) and increased robustness of correctness across models (mean 0.74 vs. 0.81). Majority consensus also increased overall (P<0.001). Consensus strength and robust correctness remained correlated under both strategies (ho=0.88 for zero-shot; ho=0.87 for agentic), although high agreement did not guarantee correctness. Response verbosity showed no meaningful association with correctness. Among 572 incorrect outputs, 72% were associated with moderate or high clinically assessed severity, although inter-rater agreement was low (appa=0.02). Agentic retrieval therefore was associated with more concentrated decision distributions, stronger consensus, and higher cross-model robustness of correctness. These findings suggest that evaluating agentic systems through accuracy or agreement alone may not always be sufficient, and that complementary analyses of stability, cross-model robustness, and potential clinical impact are needed to characterize reliability under model variability.

  • 12 authors
·
Mar 6

From Questions to Clinical Recommendations: Large Language Models Driving Evidence-Based Clinical Decision Making

Clinical evidence, derived from rigorous research and data analysis, provides healthcare professionals with reliable scientific foundations for informed decision-making. Integrating clinical evidence into real-time practice is challenging due to the enormous workload, complex professional processes, and time constraints. This highlights the need for tools that automate evidence synthesis to support more efficient and accurate decision making in clinical settings. This study introduces Quicker, an evidence-based clinical decision support system powered by large language models (LLMs), designed to automate evidence synthesis and generate clinical recommendations modeled after standard clinical guideline development processes. Quicker implements a fully automated chain that covers all phases, from questions to clinical recommendations, and further enables customized decision-making through integrated tools and interactive user interfaces. To evaluate Quicker's capabilities, we developed the Q2CRBench-3 benchmark dataset, based on clinical guideline development records for three different diseases. Experimental results highlighted Quicker's strong performance, with fine-grained question decomposition tailored to user preferences, retrieval sensitivities comparable to human experts, and literature screening performance approaching comprehensive inclusion of relevant studies. In addition, Quicker-assisted evidence assessment effectively supported human reviewers, while Quicker's recommendations were more comprehensive and logically coherent than those of clinicians. In system-level testing, collaboration between a single reviewer and Quicker reduced the time required for recommendation development to 20-40 minutes. In general, our findings affirm the potential of Quicker to help physicians make quicker and more reliable evidence-based clinical decisions.

  • 16 authors
·
May 15, 2025

Evidence-Grounded Ensemble Diagnosis of 802.11 Packet Captures: A Multi-Stage Pipeline with Deterministic Reliability Scoring

Diagnosing 802.11 packet captures requires expert protocol knowledge, is slow, inconsistent across engineers, and unscalable. LLM-based approaches sound plausible but fabricate protocol events absent from captures (especially truncated traces), produce uncalibrated confidence scores, and suffer evaluation bias when golden references are co-produced by the model under test. We introduce PROBE (Protocol Reasoning Over evidence-Based Ensembles), a multi-stage pipeline addressing all three failures. It integrates (i) deterministic PCAP-to-text normalization with frame-level verifiability, (ii) multi-run, multi-candidate ensembles with optional cross-model second opinion and progressive obfuscation, (iii) a verdict-aware evidence framework treating absence of failure evidence as contributing evidence, and (iv) a fully deterministic composite reliability score from evidence validity, run-to-run stability, and cross-model agreement without LLM self-assessment. On 87 enterprise Wi-Fi captures (104 capture-reviewer pairs), single-pass LLM analysis raises weighted evidence F1 from 0.871 (expert baseline) to 0.912 but misses critical frames in 35% of cases. Naive ensemble voting drops below baseline (0.842) as majority voting amplifies conservative verdicts: 50% of confirmed failures are misclassified as 'no issue' or 'insufficient evidence.' Adding evidence-grounded reconciliation achieves 0.957 F1, a 96% auto-accept rate, and a worst-case floor above 0.70. LLM self-reported confidence clusters at 0.95 regardless of difficulty (71% report exactly 0.95), confirming it is uninformative. We also introduce a model-agnostic evaluation framework using per-field assertion matching, eliminating circular bias from model-co-produced golden references.

  • 3 authors
·
Jun 4

ClinSeekAgent: Automating Multimodal Evidence Seeking for Agentic Clinical Reasoning

Large language models (LLMs) and agentic systems have shown promise for clinical decision support, but existing works largely assume that evidence has already been curated and handed to the model. Real-world clinical workflows instead require agents to actively seek, iteratively plan, and synthesize multimodal evidence from heterogeneous sources. In this paper, we introduce ClinSeekAgent, an automated agentic framework for dynamic multimodal evidence seeking that shifts the paradigm from passive evidence consumption to active evidence acquisition. Given only a clinical query and access to raw data sources, ClinSeekAgent gathers evidence by querying medical knowledge bases, navigating raw EHRs, and invoking medical imaging tools; refines its hypotheses as new information emerges; and integrates the collected evidence into grounded clinical decisions. ClinSeekAgent serves both as an inference-time agent for frontier LLMs and as a training-time pipeline for distilling high-quality agent trajectories into compact open-source models. To validate its inference-time effectiveness, we construct ClinSeek-Bench, which pairs Curated Input reasoning from fixed pre-selected evidence with Automated Evidence-Seeking over raw clinical data. On text-only EHR tasks, ClinSeekAgent improves Claude Opus 4.6 from 60.0 to 63.2 overall F1 and MiniMax M2.5 from 43.1 to 47.3, with positive risk-prediction gains in 7 out of 9 evaluated host models. On multimodal tasks, ClinSeekAgent improves Claude Opus 4.6 from 47.5 to 62.6 (+15.1); all evaluated models improve across the three CXR-related task groups. We further validate ClinSeekAgent as a training pipeline by distilling agentic evidence-seeking trajectories into ClinSeek-35B-A3B, which achieves 34.0 average F1 on existing AgentEHR-Bench, improving over its Qwen3.5-35B-A3B baseline by +11.9 points and approaching Claude Opus 4.6.

UCSC-VLAA UCSC-VLAA
·
May 18 2

Serialisation Strategy Matters: How FHIR Data Format Affects LLM Medication Reconciliation

Medication reconciliation at clinical handoffs is a high-stakes, error-prone process. Large language models are increasingly proposed to assist with this task using FHIR-structured patient records, but a fundamental and largely unstudied variable is how the FHIR data is serialised before being passed to the model. We present the first systematic comparison of four FHIR serialisation strategies (Raw JSON, Markdown Table, Clinical Narrative, and Chronological Timeline) across five open-weight models (Phi-3.5-mini, Mistral-7B, BioMistral-7B, Llama-3.1-8B, Llama-3.3-70B) on a controlled benchmark of 200 synthetic patients, totalling 4,000 inference runs. We find that serialisation strategy has a large, statistically significant effect on performance for models up to 8B parameters: Clinical Narrative outperforms Raw JSON by up to 19 F1 points for Mistral-7B (r = 0.617, p < 10^{-10}). This advantage reverses at 70B, where Raw JSON achieves the best mean F1 of 0.9956. In all 20 model and strategy combinations, mean precision exceeds mean recall: omission is the dominant failure mode, with models more often missing an active medication than fabricating one, which changes how clinical safety auditing priorities should be set. Smaller models plateau at roughly 7-10 concurrent active medications, leaving polypharmacy patients, the patients most at risk from reconciliation errors, systematically underserved. BioMistral-7B, a domain-pretrained model without instruction tuning, produces zero usable output in all conditions, showing that domain pretraining alone is not sufficient for structured extraction. These results offer practical, evidence-based format recommendations for clinical LLM deployment: Clinical Narrative for models up to 8B, Raw JSON for 70B and above. The complete pipeline is reproducible on open-source tools running on an AWS g6e.xlarge instance (NVIDIA L40S, 48 GB VRAM).

  • 1 authors
·
Apr 21

Disagreement as a way to study misinformation and its effects

Misinformation - false or misleading information - is considered a significant societal concern due to its associated "misinformation effects," such as political polarization, erosion of trust in institutions, problematic behavior, and public health challenges. However, the prevailing concept is misaligned with what is studied. While misinformation focuses on instances of information about factual matters, the broad spectrum of effects often manifests at a societal level and is shaped by a wide range of interdependent factors such as identity, values, opinions, epistemologies, and disagreements. Unsurprisingly, misinformation effects can occur without the prevalence of misinformation, and misinformation does not necessarily increase the effects studied. Here, we propose using disagreement - conflicting attitudes and beliefs between individuals and communities - as a way to study misinformation effects because it addresses the identified conceptual limitations of misinformation. Furthermore, unlike misinformation, disagreement does not require researchers to determine whether a given information is false or misleading. Thus, it can be studied and, more importantly, measured without the need to make a normative judgment about a given information, even when the specific topic is entirely removed, as we show in a longitudinal disagreement measurement. We demonstrate that disagreement, as a holistic concept, provides better explanations for the occurrence of misinformation effects, enhances precision in developing appropriate interventions, and offers a promising approach for evaluating them through quantification. Finally, we show how disagreement addresses current misinformation research questions and conclude with recommendations for research practice.

  • 2 authors
·
Aug 15, 2024

ReFIne: A Framework for Trustworthy Large Reasoning Models with Reliability, Faithfulness, and Interpretability

Recent advances in long chain-of-thought (CoT) reasoning have largely prioritized answer accuracy and token efficiency, while overlooking aspects critical to trustworthiness. We argue that usable reasoning systems must be trustworthy, characterized by three properties: interpretability, faithfulness, and reliability. To this end, we propose ReFIne, a new training framework that integrates supervised fine-tuning with GRPO to encourage models to: (i) improve interpretability by producing structured, tag-based traces with high-level planning that are easier for humans to follow; (ii) enhance faithfulness by explicitly disclosing the decisive information guiding each solution, with consistent cross-section references; and (iii) promote reliability by providing self-assessments of both the derivation's soundness and the confidence of the final answer. We apply ReFIne to the Qwen3 models at multiple scales (1.7B/4B/8B) and evaluate across mathematical benchmarks of varying difficulty. Our experimental results show that ReFIne models generate clearer and better-structured reasoning traces (interpretability +44.0%), more faithfully expose their underlying decision process (faithfulness +18.8%), and offer informative confidence estimates (reliability +42.4%). These findings highlight an overlooked but important direction: reasoning models should be optimized not only for accuracy, but also for broader dimensions of trustworthiness. Our code is available at: https://github.com/Trustworthy-ML-Lab/Training_Trustworthy_LRM_with_Refine

  • 4 authors
·
Oct 10, 2025 2

CARE: Privacy-Compliant Agentic Reasoning with Evidence Discordance

Large language model (LLM) systems are increasingly used to support high-stakes decision-making, but they typically perform worse when the available evidence is internally inconsistent. Such a scenario exists in real-world healthcare settings, with patient-reported symptoms contradicting medical signs. To study this problem, we introduce MIMIC-DOS, a dataset for short-horizon organ dysfunction worsening prediction in the intensive care unit (ICU) setting. We derive this dataset from the widely recognized MIMIC-IV, a publicly available electronic health record dataset, and construct it exclusively from cases in which discordance between signs and symptoms exists. This setting poses a substantial challenge for existing LLM-based approaches, with single-pass LLMs and agentic pipelines often struggling to reconcile such conflicting signals. To address this problem, we propose CARE: a multi-stage privacy-compliant agentic reasoning framework in which a remote LLM provides guidance by generating structured categories and transitions without accessing sensitive patient data, while a local LLM uses these categories and transitions to support evidence acquisition and final decision-making. Empirically, CARE achieves stronger performance across all key metrics compared to multiple baseline settings, showing that CARE can more robustly handle conflicting clinical evidence while preserving privacy.

Beyond Monolingual Deep Research: Evaluating Agents and Retrievers with Cross-Lingual BrowseComp-Plus

Deep research agents are increasingly evaluated on their ability to search for evidence, reason over retrieved sources, and produce grounded answers. Existing browsing benchmarks, however, largely assume that the user's query and the supporting evidence are written in the same language, leaving open whether agentic search systems can operate when relevant evidence appears in another language. We introduce XBCP (Cross-lingual BrowseComp-Plus), a controlled benchmark that preserves the English question-and-answer space of BrowseComp-Plus but varies the languages of the supporting documents. XBCP instantiates two complementary settings: in the cross-lingual setting, each query is paired with evidence in a single assigned language. In the multilingual setting, the full evidence corpus is distributed equally and randomly across 12 languages spanning high-resource and low-resource regimes. We evaluate four deep research agents using sparse and dense multilingual retrievers, measuring answer accuracy, evidence recall, search behavior, calibration, citation fidelity, and oracle retrieval. Results reveal substantial degradation when evidence is translated. Even strong, dense retrievers lose evidence recall, and agents become less calibrated and cite evidence less reliably. Notably, accuracy remains lower even when all gold evidence is supplied directly. These findings suggest that cross-lingual deep research exposes both retrieval failures and an independent, agent-side difficulty in integrating language-mismatched evidence.

Pipeline and Dataset Generation for Automated Fact-checking in Almost Any Language

This article presents a pipeline for automated fact-checking leveraging publicly available Language Models and data. The objective is to assess the accuracy of textual claims using evidence from a ground-truth evidence corpus. The pipeline consists of two main modules -- the evidence retrieval and the claim veracity evaluation. Our primary focus is on the ease of deployment in various languages that remain unexplored in the field of automated fact-checking. Unlike most similar pipelines, which work with evidence sentences, our pipeline processes data on a paragraph level, simplifying the overall architecture and data requirements. Given the high cost of annotating language-specific fact-checking training data, our solution builds on the Question Answering for Claim Generation (QACG) method, which we adapt and use to generate the data for all models of the pipeline. Our strategy enables the introduction of new languages through machine translation of only two fixed datasets of moderate size. Subsequently, any number of training samples can be generated based on an evidence corpus in the target language. We provide open access to all data and fine-tuned models for Czech, English, Polish, and Slovak pipelines, as well as to our codebase that may be used to reproduce the results.We comprehensively evaluate the pipelines for all four languages, including human annotations and per-sample difficulty assessment using Pointwise V-information. The presented experiments are based on full Wikipedia snapshots to promote reproducibility. To facilitate implementation and user interaction, we develop the FactSearch application featuring the proposed pipeline and the preliminary feedback on its performance.

  • 4 authors
·
Dec 15, 2023

RISED: A Pre-Deployment Evaluation Framework for High-Stakes AI Decision-Support Systems, with Application to Healthcare

Clinical decision-support systems are expert systems whose recommendations clinicians act on directly, yet they are usually cleared on one aggregate accuracy number from a held-out test set. That number says nothing about input reliability under encoding shifts, subgroup gaps, threshold sensitivity, or operational feasibility. We present RISED, a pre-deployment evaluation framework operationalising five dimensions (Reliability, Inclusivity, Sensitivity, Equity, Deployability) through BCa bootstrap 95% confidence intervals, literature-grounded thresholds, and Holm-Bonferroni-corrected PASS / FAIL / INCONCLUSIVE verdicts; Equity is a proxy-dependence diagnostic rather than a gating test. Applied to seven cohorts spanning 35 years (n from 303 to 99,492), RISED surfaces failures invisible to AUROC: on Diabetes 130, Reliability passes by three orders of magnitude (PSS = 0.0004) while Inclusivity (AUC parity gap = 0.262) and Sensitivity (max threshold-flip rate 49.1%) fail decisively; both NHIS cohorts reproduce this. NHANES 2021-2023, with a complete feature profile, achieves INCONCLUSIVE verdicts; BRFSS 2024 produces the suite's most severe Sensitivity failure (max threshold-flip rate 64.2%) after instrument rotation removed hypertension and cholesterol. The pattern recurs on credit- and income-prediction cohorts, confirming domain-agnosticity; a multi-model check shows the failures are data-driven, not model-specific. RISED ships as an open-source Python package complementing TRIPOD+AI, FUTURE-AI, and Fairlearn with the structured numerical evidence those standards require but do not prescribe.

  • 5 authors
·
May 29

Empirical Characterization of Rationale Stability Under Controlled Perturbations for Explainable Pattern Recognition

Reliable pattern recognition systems should exhibit consistent behavior across similar inputs, and their explanations should remain stable. However, most Explainable AI evaluations remain instance centric and do not explicitly quantify whether attribution patterns are consistent across samples that share the same class or represent small variations of the same input. In this work, we propose a novel metric aimed at assessing the consistency of model explanations, ensuring that models consistently reflect the intended objectives and consistency under label-preserving perturbations. We implement this metric using a pre-trained BERT model on the SST-2 sentiment analysis dataset, with additional robustness tests on RoBERTa, DistilBERT, and IMDB, applying SHAP to compute feature importance for various test samples. The proposed metric quantifies the cosine similarity of SHAP values for inputs with the same label, aiming to detect inconsistent behaviors, such as biased reliance on certain features or failure to maintain consistent reasoning for similar predictions. Through a series of experiments, we evaluate the ability of this metric to identify misaligned predictions and inconsistencies in model explanations. These experiments are compared against standard fidelity metrics to assess whether the new metric can effectively identify when a model's behavior deviates from its intended objectives. The proposed framework provides a deeper understanding of model behavior by enabling more robust verification of rationale stability, which is critical for building trustworthy AI systems. By quantifying whether models rely on consistent attribution patterns for similar inputs, the proposed approach supports more robust evaluation of model behavior in practical pattern recognition pipelines. Our code is publicly available at https://github.com/anmspro/ESS-XAI-Stability.

  • 4 authors
·
Apr 5

LabSafety Bench: Benchmarking LLMs on Safety Issues in Scientific Labs

Laboratory accidents pose significant risks to human life and property, underscoring the importance of robust safety protocols. Despite advancements in safety training, laboratory personnel may still unknowingly engage in unsafe practices. With the increasing reliance on large language models (LLMs) for guidance in various fields, including laboratory settings, there is a growing concern about their reliability in critical safety-related decision-making. Unlike trained human researchers, LLMs lack formal lab safety education, raising questions about their ability to provide safe and accurate guidance. Existing research on LLM trustworthiness primarily focuses on issues such as ethical compliance, truthfulness, and fairness but fails to fully cover safety-critical real-world applications, like lab safety. To address this gap, we propose the Laboratory Safety Benchmark (LabSafety Bench), a comprehensive evaluation framework based on a new taxonomy aligned with Occupational Safety and Health Administration (OSHA) protocols. This benchmark includes 765 multiple-choice questions verified by human experts, assessing LLMs and vision language models (VLMs) performance in lab safety contexts. Our evaluations demonstrate that while GPT-4o outperforms human participants, it is still prone to critical errors, highlighting the risks of relying on LLMs in safety-critical environments. Our findings emphasize the need for specialized benchmarks to accurately assess the trustworthiness of LLMs in real-world safety applications.

  • 9 authors
·
Oct 18, 2024 1

Reflecting on Motivations: How Reasons to Publish affect Research Behaviour in Astronomy

Recent research in the field of reflexive metrics have studied the emergence and consequences of evaluation gaps in science. The concept of evaluation gaps captures potential discrepancies between what researchers value about their research, in particular research quality, and what metrics measure. As a result, scientists may experience anomie and adopt innovative ways to cope. These often value quantity over quality and may even compromise research integrity. A consequence of such gaps may therefore be research misconduct and a decrease in research quality. In the language of rational choice theory, an evaluation gap persists if motivational factors arising out of the internal component of an actors situation are incongruent with those arising out of the external components. The aim of this research is therefore to study and compare autonomous and controlled motivations to become an astronomer, to do research in astronomy and to publish scientific papers. Moreover, we study how these different motivational factors affect publication pressure, the experience of organisational justice and the observation of research misconduct. In summary, we find evidence for an evaluation gap and that controlled motivational factors arising from evaluation procedures based on publication record drives up publication pressure, which, in turn, was found to increase the likelihood of perceived frequency of misbehaviour.

  • 1 authors
·
Nov 30, 2021

Evaluating Consistency and Reasoning Capabilities of Large Language Models

Large Language Models (LLMs) are extensively used today across various sectors, including academia, research, business, and finance, for tasks such as text generation, summarization, and translation. Despite their widespread adoption, these models often produce incorrect and misleading information, exhibiting a tendency to hallucinate. This behavior can be attributed to several factors, with consistency and reasoning capabilities being significant contributors. LLMs frequently lack the ability to generate explanations and engage in coherent reasoning, leading to inaccurate responses. Moreover, they exhibit inconsistencies in their outputs. This paper aims to evaluate and compare the consistency and reasoning capabilities of both public and proprietary LLMs. The experiments utilize the Boolq dataset as the ground truth, comprising questions, answers, and corresponding explanations. Queries from the dataset are presented as prompts to the LLMs, and the generated responses are evaluated against the ground truth answers. Additionally, explanations are generated to assess the models' reasoning abilities. Consistency is evaluated by repeatedly presenting the same query to the models and observing for variations in their responses. For measuring reasoning capabilities, the generated explanations are compared to the ground truth explanations using metrics such as BERT, BLEU, and F-1 scores. The findings reveal that proprietary models generally outperform public models in terms of both consistency and reasoning capabilities. However, even when presented with basic general knowledge questions, none of the models achieved a score of 90\% in both consistency and reasoning. This study underscores the direct correlation between consistency and reasoning abilities in LLMs and highlights the inherent reasoning challenges present in current language models.

  • 3 authors
·
Apr 25, 2024

Med-V1: Small Language Models for Zero-shot and Scalable Biomedical Evidence Attribution

Assessing whether an article supports an assertion is essential for hallucination detection and claim verification. While large language models (LLMs) have the potential to automate this task, achieving strong performance requires frontier models such as GPT-5 that are prohibitively expensive to deploy at scale. To efficiently perform biomedical evidence attribution, we present Med-V1, a family of small language models with only three billion parameters. Trained on high-quality synthetic data newly developed in this study, Med-V1 substantially outperforms (+27.0% to +71.3%) its base models on five biomedical benchmarks unified into a verification format. Despite its smaller size, Med-V1 performs comparably to frontier LLMs such as GPT-5, along with high-quality explanations for its predictions. We use Med-V1 to conduct a first-of-its-kind use case study that quantifies hallucinations in LLM-generated answers under different citation instructions. Results show that the format instruction strongly affects citation validity and hallucination, with GPT-5 generating more claims but exhibiting hallucination rates similar to GPT-4o. Additionally, we present a second use case showing that Med-V1 can automatically identify high-stakes evidence misattributions in clinical practice guidelines, revealing potentially negative public health impacts that are otherwise challenging to identify at scale. Overall, Med-V1 provides an efficient and accurate lightweight alternative to frontier LLMs for practical and real-world applications in biomedical evidence attribution and verification tasks. Med-V1 is available at https://github.com/ncbi-nlp/Med-V1.

  • 15 authors
·
Mar 5

Time to REFLECT: Can We Trust LLM Judges for Evidence-based Research Agents?

Deep research agents increasingly automate complex information-seeking tasks, producing evidence-grounded reports via multi-step reasoning, tool use, and synthesis. Their growing role demands scalable, reliable evaluation, positioning LLM-as-judge as a supervision paradigm for assessing factual accuracy, evidence use, and reasoning quality. Yet the reliability of these judges for deep research agents remains poorly understood, posing a critical meta-evaluation problem: before deploying LLM judges to supervise research agents, we must first evaluate the judges themselves. Existing meta-evaluations fall short in two ways: (1) reliance on coarse, subjective human-preference agreement; (2) focus on instruction-following or verifiable tasks, leaving open-ended agent executions unexplored. To address these gaps, we introduce REFLECT (REliable Fine-grained LLM judge Evaluation via Controlled inTervention), a meta-evaluation benchmark targeting fine-grained failure detection in agentic environments. REFLECT defines a detailed taxonomy of process- and outcome-level failure modes, instantiated by performing controlled and localized interventions on quality-screened agent execution traces. This yields verifiable, comprehensive, and fine-grained instances for validating the judge models. Our experiments show that current LLM judges remain unreliable: even the best-performing models achieve overall accuracies below 55% across reasoning, tool-use, and report-quality failures, with especially poor performance on evidence verification. Together, our taxonomy and findings expose systematic judge limitations, reveal tradeoffs in cost and reliability, and offer actionable guidance for building more reliable evaluation pipelines for deep research agents.

  • 8 authors
·
May 17

Theoretical Foundations of Latent Posterior Factors: Formal Guarantees for Multi-Evidence Reasoning

We present a complete theoretical characterization of Latent Posterior Factors (LPF), a principled framework for aggregating multiple heterogeneous evidence items in probabilistic prediction tasks. Multi-evidence reasoning arises pervasively in high-stakes domains including healthcare diagnosis, financial risk assessment, legal case analysis, and regulatory compliance, yet existing approaches either lack formal guarantees or fail to handle multi-evidence scenarios architecturally. LPF encodes each evidence item into a Gaussian latent posterior via a variational autoencoder, converting posteriors to soft factors through Monte Carlo marginalization, and aggregating factors via exact Sum-Product Network inference (LPF-SPN) or a learned neural aggregator (LPF-Learned). We prove seven formal guarantees spanning the key desiderata for trustworthy AI: Calibration Preservation (ECE <= epsilon + C/sqrt(K_eff)); Monte Carlo Error decaying as O(1/sqrt(M)); a non-vacuous PAC-Bayes bound with train-test gap of 0.0085 at N=4200; operation within 1.12x of the information-theoretic lower bound; graceful degradation as O(epsilon*delta*sqrt(K)) under corruption, maintaining 88% performance with half of evidence adversarially replaced; O(1/sqrt(K)) calibration decay with R^2=0.849; and exact epistemic-aleatoric uncertainty decomposition with error below 0.002%. All theorems are empirically validated on controlled datasets spanning up to 4,200 training examples. Our theoretical framework establishes LPF as a foundation for trustworthy multi-evidence AI in safety-critical applications.

  • 1 authors
·
Mar 13 2

MedSkillAudit: A Domain-Specific Audit Framework for Medical Research Agent Skills

Background: Agent skills are increasingly deployed as modular, reusable capability units in AI agent systems. Medical research agent skills require safeguards beyond general-purpose evaluation, including scientific integrity, methodological validity, reproducibility, and boundary safety. This study developed and preliminarily evaluated a domain-specific audit framework for medical research agent skills, with a focus on reliability against expert review. Methods: We developed MedSkillAudit (skill-auditor@1.0), a layered framework assessing skill release readiness before deployment. We evaluated 75 skills across five medical research categories (15 per category). Two experts independently assigned a quality score (0-100), an ordinal release disposition (Production Ready / Limited Release / Beta Only / Reject), and a high-risk failure flag. System-expert agreement was quantified using ICC(2,1) and linearly weighted Cohen's kappa, benchmarked against the human inter-rater baseline. Results: The mean consensus quality score was 72.4 (SD = 13.0); 57.3% of skills fell below the Limited Release threshold. MedSkillAudit achieved ICC(2,1) = 0.449 (95% CI: 0.250-0.610), exceeding the human inter-rater ICC of 0.300. System-consensus score divergence (SD = 9.5) was smaller than inter-expert divergence (SD = 12.4), with no directional bias (Wilcoxon p = 0.613). Protocol Design showed the strongest category-level agreement (ICC = 0.551); Academic Writing showed a negative ICC (-0.567), reflecting a structural rubric-expert mismatch. Conclusions: Domain-specific pre-deployment audit may provide a practical foundation for governing medical research agent skills, complementing general-purpose quality checks with structured audit workflows tailored to scientific use cases.

AIPOCH-AI AIPOCH
·
Apr 21 2

From Documents to Spans: Scalable Supervision for Evidence-Based ICD Coding with LLMs

International Classification of Diseases (ICD) coding assigns diagnosis codes to clinical documents and is essential for healthcare billing and clinical analysis. Reliable coding requires that each predicted code be supported by explicit textual evidence. However, existing public datasets provide only code labels, without evidence annotations, limiting models' ability to learn evidence-grounded predictions. In this work, we argue that dense, document-level evidence annotation is not always necessary for learning evidence-based coding. Instead, models can learn code-specific evidence patterns from local spans and use these patterns to support document-level evidence-based coding. Based on this insight, we propose Span-Centric Learning (SCL), a training framework that strengthens LLMs' coding ability at the span level and transfers this capability to full clinical documents. Specifically, we use a small set of annotated documents to supervise evidence recognition, aggregation, and code assignment, while leveraging a large collection of lightweight evidence spans to reinforce span-level reasoning. Due to their compactness, span annotations are scalable and can be further augmented through synthesis. Under the same Llama3.1-8B backbone, our approach achieves an 8.2-point improvement in macro-F1 at only 20% of the training cost of standard SFT, and provides explicit supporting evidence for each predicted code, enabling human auditing and revision.

  • 8 authors
·
May 6

From Faithfulness to Correctness: Generative Reward Models that Think Critically

Through reinforcement learning with verifiable rewards (RLVR), large language models have achieved substantial progress in domains with easily verifiable outcomes, such as mathematics and coding. However, when applied to more complex tasks like open-domain question answering, RLVR faces significant challenges due to the difficulty of verifying correctness. The nuanced and ambiguous nature of real-world knowledge makes it difficult to reliably evaluate correctness in these settings, necessitating further abilities that extend beyond mere logical consistency to encompass an understanding and assessment of both external and internal knowledge. Recent work has primarily focused on improving faithfulness, defined as semantic alignment with supporting documents, which can cause models to rely excessively on external sources and diminish their capacity for critical assessment. To address this, we propose the Thinking-supervised Reward Model (TRM), which incorporates sentence-level thinking supervision to endow reward models with critical thinking abilities. Given a query, answer, and supporting documents, TRM first assesses the faithfulness of each answer sentence to the supporting documents, and then applies a reasoning step to evaluate sentence-level correctness. By structuring reward modeling as a sequence of faithfulness, reasoning, and correctness evaluations, TRM encourages models to critically assess and leverage both external and internal knowledge. Experiments on reward signals demonstrate that TRM substantially improves the identification of incorrect sentences, and incorporating TRM into policy optimization leads to significant gains in both answer correctness and usefulness.

  • 6 authors
·
Sep 29, 2025

ARIS: Autonomous Research via Adversarial Multi-Agent Collaboration

This report describes ARIS (Auto-Research-in-sleep), an open-source research harness for autonomous research, including its architecture, assurance mechanisms, and early deployment experience. The performance of agent systems built on LLMs depends on both the model weights and the harness around them, which governs what information to store, retrieve, and present to the model. For long-horizon research workflows, the central failure mode is not a visible breakdown but a plausible unsupported success: a long-running agent can produce claims whose evidential support is incomplete, misreported, or silently inherited from the executor's framing. Therefore, we present ARIS as a research harness that coordinates machine-learning research workflows through cross-model adversarial collaboration as a default configuration: an executor model drives forward progress while a reviewer from a different model family is recommended to critique intermediate artifacts and request revisions. ARIS has three architectural layers. The execution layer provides more than 65 reusable Markdown-defined skills, model integrations via MCP, a persistent research wiki for iterative reuse of prior findings, and deterministic figure generation. The orchestration layer coordinates five end-to-end workflows with adjustable effort settings and configurable routing to reviewer models. The assurance layer includes a three-stage process for checking whether experimental claims are supported by evidence: integrity verification, result-to-claim mapping, and claim auditing that cross-checks manuscript statements against the claim ledger and raw evidence, as well as a five-pass scientific-editing pipeline, mathematical-proof checks, and visual inspection of the rendered PDF. A prototype self-improvement loop records research traces and proposes harness improvements that are adopted only after reviewer approval.