Daily Papers

Large Language Models (LLMs) have shown remarkable capabilities as AI agents. However, existing methods for enhancing LLM-agent abilities often lack a focus on data quality, leading to inefficiencies and suboptimal results in both fine-tuning and prompt engineering. To address this issue, we introduce EDGE, a novel approach for identifying informative samples without needing golden answers. We propose the Guideline Effectiveness (GE) metric, which selects challenging samples by measuring the impact of human-provided guidelines in multi-turn interaction tasks. A low GE score indicates that the human expertise required for a sample is missing from the guideline, making the sample more informative. By selecting samples with low GE scores, we can improve the efficiency and outcomes of both prompt engineering and fine-tuning processes for LLMs. Extensive experiments validate the performance of our method. Our method achieves competitive results on the HotpotQA and WebShop and datasets, requiring 75\% and 50\% less data, respectively, while outperforming existing methods. We also provide a fresh perspective on the data quality of LLM-agent fine-tuning.

Large Language Models, particularly decoder-only generative models such as GPT, are increasingly used to automate Software Engineering tasks. These models are primarily guided through natural language prompts, making prompt engineering a critical factor in system performance and behavior. Despite their growing role in SE research, prompt-related decisions are rarely documented in a systematic or transparent manner, hindering reproducibility and comparability across studies. To address this gap, we conducted a two-phase empirical study. First, we analyzed nearly 300 papers published at the top-3 SE conferences since 2022 to assess how prompt design, testing, and optimization are currently reported. Second, we surveyed 105 program committee members from these conferences to capture their expectations for prompt reporting in LLM-driven research. Based on the findings, we derived a structured guideline that distinguishes essential, desirable, and exceptional reporting elements. Our results reveal significant misalignment between current practices and reviewer expectations, particularly regarding version disclosure, prompt justification, and threats to validity. We present our guideline as a step toward improving transparency, reproducibility, and methodological rigor in LLM-based SE research.

We introduce the Agent GPA (Goal-Plan-Action) framework: an evaluation paradigm based on an agent's operational loop of setting goals, devising plans, and executing actions. The framework includes five evaluation metrics: Goal Fulfillment, Logical Consistency, Execution Efficiency, Plan Quality, and Plan Adherence. Logical Consistency checks that an agent's actions are consistent with its prior actions. Execution Efficiency checks whether the agent executes in the most efficient way to achieve its goal. Plan Quality checks whether an agent's plans are aligned with its goals; Plan Adherence checks if an agent's actions are aligned with its plan; and Goal Fulfillment checks that agent's final outcomes match the stated goals. Our experimental results on two benchmark datasets - the public TRAIL/GAIA dataset and an internal dataset for a production-grade data agent - show that this framework (a) provides a systematic way to cover a broad range of agent failures, including all agent errors on the TRAIL/GAIA benchmark dataset; (b) supports LLM-judges that exhibit strong agreement with human annotation, covering 80% to over 95% errors; and (c) localizes errors with 86% agreement to enable targeted improvement of agent performance.

Recent popularity surrounds large AI language models due to their impressive natural language capabilities. They contribute significantly to language-related tasks, including prompt-based learning, making them valuable for various specific tasks. This approach unlocks their full potential, enhancing precision and generalization. Research communities are actively exploring their applications, with ChatGPT receiving recognition. Despite extensive research on large language models, their potential in recommendation scenarios still needs to be explored. This study aims to fill this gap by investigating ChatGPT's capabilities as a zero-shot recommender system. Our goals include evaluating its ability to use user preferences for recommendations, reordering existing recommendation lists, leveraging information from similar users, and handling cold-start situations. We assess ChatGPT's performance through comprehensive experiments using three datasets (MovieLens Small, Last.FM, and Facebook Book). We compare ChatGPT's performance against standard recommendation algorithms and other large language models, such as GPT-3.5 and PaLM-2. To measure recommendation effectiveness, we employ widely-used evaluation metrics like Mean Average Precision (MAP), Recall, Precision, F1, normalized Discounted Cumulative Gain (nDCG), Item Coverage, Expected Popularity Complement (EPC), Average Coverage of Long Tail (ACLT), Average Recommendation Popularity (ARP), and Popularity-based Ranking-based Equal Opportunity (PopREO). Through thoroughly exploring ChatGPT's abilities in recommender systems, our study aims to contribute to the growing body of research on the versatility and potential applications of large language models. Our experiment code is available on the GitHub repository: https://github.com/sisinflab/Recommender-ChatGPT

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.

Evaluating the performance of Grammatical Error Correction (GEC) models has become increasingly challenging, as large language model (LLM)-based GEC systems often produce corrections that diverge from provided gold references. This discrepancy undermines the reliability of traditional reference-based evaluation metrics. In this study, we propose a novel evaluation framework for GEC models, DSGram, integrating Semantic Coherence, Edit Level, and Fluency, and utilizing a dynamic weighting mechanism. Our framework employs the Analytic Hierarchy Process (AHP) in conjunction with large language models to ascertain the relative importance of various evaluation criteria. Additionally, we develop a dataset incorporating human annotations and LLM-simulated sentences to validate our algorithms and fine-tune more cost-effective models. Experimental results indicate that our proposed approach enhances the effectiveness of GEC model evaluations.

We introduce gec-metrics, a library for using and developing grammatical error correction (GEC) evaluation metrics through a unified interface. Our library enables fair system comparisons by ensuring that everyone conducts evaluations using a consistent implementation. Moreover, it is designed with a strong focus on API usage, making it highly extensible. It also includes meta-evaluation functionalities and provides analysis and visualization scripts, contributing to developing GEC evaluation metrics. Our code is released under the MIT license and is also distributed as an installable package. The video is available on YouTube.

Large Language Models (LLMs) have demonstrated considerable potential in general practice. However, existing benchmarks and evaluation frameworks primarily depend on exam-style or simplified question-answer formats, lacking a competency-based structure aligned with the real-world clinical responsibilities encountered in general practice. Consequently, the extent to which LLMs can reliably fulfill the duties of general practitioners (GPs) remains uncertain. In this work, we propose a novel evaluation framework to assess the capability of LLMs to function as GPs. Based on this framework, we introduce a general practice benchmark (GPBench), whose data are meticulously annotated by domain experts in accordance with routine clinical practice standards. We evaluate ten state-of-the-art LLMs and analyze their competencies. Our findings indicate that current LLMs are not yet ready for deployment in such settings without human oversight, and further optimization specifically tailored to the daily responsibilities of GPs is essential.

Large Language Models (LLMs) exhibit impressive capabilities but also present risks such as biased content generation and privacy issues. One of the current alignment techniques includes principle-driven integration, but it faces challenges arising from the imprecision of manually crafted rules and inadequate risk perception in models without safety training. To address these, we introduce Guide-Align, a two-stage approach. Initially, a safety-trained model identifies potential risks and formulates specific guidelines for various inputs, establishing a comprehensive library of guidelines and a model for input-guidelines retrieval. Subsequently, the retrieval model correlates new inputs with relevant guidelines, which guide LLMs in response generation to ensure safe and high-quality outputs, thereby aligning with human values. An additional optional stage involves fine-tuning a model with well-aligned datasets generated through the process implemented in the second stage. Our method customizes guidelines to accommodate diverse inputs, thereby enhancing the fine-grainedness and comprehensiveness of the guideline library. Furthermore, it incorporates safety expertise from a safety-trained LLM through a lightweight retrieval model. We evaluate our approach on three benchmarks, demonstrating significant improvements in LLM security and quality. Notably, our fine-tuned model, Labrador, even at 13 billion parameters, outperforms GPT-3.5-turbo and surpasses GPT-4 in alignment capabilities.

The National Comprehensive Cancer Network (NCCN) provides evidence-based guidelines for cancer treatment. Translating complex patient presentations into guideline-compliant treatment recommendations is time-intensive, requires specialized expertise, and is prone to error. Advances in large language model (LLM) capabilities promise to reduce the time required to generate treatment recommendations and improve accuracy. We present an LLM agent-based approach to automatically generate guideline-concordant treatment trajectories for patients with non-small cell lung cancer (NSCLC). Our contributions are threefold. First, we construct a novel longitudinal dataset of 121 cases of NSCLC patients that includes clinical encounters, diagnostic results, and medical histories, each expertly annotated with the corresponding NCCN guideline trajectories by board-certified oncologists. Second, we demonstrate that existing LLMs possess domain-specific knowledge that enables high-quality proxy benchmark generation for both model development and evaluation, achieving strong correlation (Spearman coefficient r=0.88, RMSE = 0.08) with expert-annotated benchmarks. Third, we develop a hybrid approach combining expensive human annotations with model consistency information to create both the agent framework that predicts the relevant guidelines for a patient, as well as a meta-classifier that verifies prediction accuracy with calibrated confidence scores for treatment recommendations (AUROC=0.800), a critical capability for communicating the accuracy of outputs, custom-tailoring tradeoffs in performance, and supporting regulatory compliance. This work establishes a framework for clinically viable LLM-based guideline adherence systems that balance accuracy, interpretability, and regulatory requirements while reducing annotation costs, providing a scalable pathway toward automated clinical decision support.

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

Introduction. Generative Artificial Intelligence, particularly large language models (LLMs), offers transformative potential for Health Economics and Outcomes Research (HEOR). However, evaluating the quality, transparency, and rigor of LLM-assisted research lacks standardized guidance. This article introduces the ELEVATE AI LLMs framework and checklist, designed to support researchers and reviewers in assessing LLM use in HEOR. Methods. The ELEVATE AI LLMs framework was developed through a targeted review of existing guidelines and evaluation frameworks. The framework comprises ten evaluation domains, including model characteristics, accuracy, comprehensiveness, and fairness. The accompanying checklist operationalizes the framework. To validate the framework, we applied it to two published studies, demonstrating its usability across different HEOR tasks. Results. The ELEVATE AI LLMs framework provides a comprehensive structure for evaluating LLM-assisted research, while the checklist facilitates practical application. Validation of the framework and checklist on studies of systematic literature reviews and health economic modeling highlighted their ability to identify strengths and gaps in reporting. Limitations. While the ELEVATE AI LLMs framework provides robust guidance, its broader generalizability and applicability to diverse HEOR tasks require further empirical testing. Additionally, several metrics adapted from computer science need further validation in HEOR contexts. Conclusion. The ELEVATE AI LLMs framework and checklist fill a critical gap in HEOR by offering structured guidance for evaluating LLM-assisted research. By promoting transparency, accuracy, and reproducibility, they aim to standardize and improve the integration of LLMs into HEOR, ensuring their outputs meet the field's rigorous standards.

We investigate the effectiveness of GPT-3.5 and GPT-4, two large language models, as Grammatical Error Correction (GEC) tools for Brazilian Portuguese and compare their performance against Microsoft Word and Google Docs. We introduce a GEC dataset for Brazilian Portuguese with four categories: Grammar, Spelling, Internet, and Fast typing. Our results show that while GPT-4 has higher recall than other methods, LLMs tend to have lower precision, leading to overcorrection. This study demonstrates the potential of LLMs as practical GEC tools for Brazilian Portuguese and encourages further exploration of LLMs for non-English languages and other educational settings.

Recent advancements in Large Language Models (LLMs) have demonstrated their potential in delivering accurate answers to questions about world knowledge. Despite this, existing benchmarks for evaluating LLMs in healthcare predominantly focus on medical doctors, leaving other critical healthcare professions underrepresented. To fill this research gap, we introduce the Examinations for Medical Personnel in Chinese (EMPEC), a pioneering large-scale healthcare knowledge benchmark in traditional Chinese. EMPEC consists of 157,803 exam questions across 124 subjects and 20 healthcare professions, including underrepresented occupations like Optometrists and Audiologists. Each question is tagged with its release time and source, ensuring relevance and authenticity. We conducted extensive experiments on 17 LLMs, including proprietary, open-source models, general domain models and medical specific models, evaluating their performance under various settings. Our findings reveal that while leading models like GPT-4 achieve over 75\% accuracy, they still struggle with specialized fields and alternative medicine. Surprisingly, general-purpose LLMs outperformed medical-specific models, and incorporating EMPEC's training data significantly enhanced performance. Additionally, the results on questions released after the models' training cutoff date were consistent with overall performance trends, suggesting that the models' performance on the test set can predict their effectiveness in addressing unseen healthcare-related queries. The transition from traditional to simplified Chinese characters had a negligible impact on model performance, indicating robust linguistic versatility. Our study underscores the importance of expanding benchmarks to cover a broader range of healthcare professions to better assess the applicability of LLMs in real-world healthcare scenarios.

We employ an audit design to investigate biases in state-of-the-art large language models, including GPT-4. In our study, we prompt the models for advice involving a named individual across a variety of scenarios, such as during car purchase negotiations or election outcome predictions. We find that the advice systematically disadvantages names that are commonly associated with racial minorities and women. Names associated with Black women receive the least advantageous outcomes. The biases are consistent across 42 prompt templates and several models, indicating a systemic issue rather than isolated incidents. While providing numerical, decision-relevant anchors in the prompt can successfully counteract the biases, qualitative details have inconsistent effects and may even increase disparities. Our findings underscore the importance of conducting audits at the point of LLM deployment and implementation to mitigate their potential for harm against marginalized communities.

There are substantial instructional videos on the Internet, which provide us tutorials for completing various tasks. Existing instructional video datasets only focus on specific steps at the video level, lacking experiential guidelines at the task level, which can lead to beginners struggling to learn new tasks due to the lack of relevant experience. Moreover, the specific steps without guidelines are trivial and unsystematic, making it difficult to provide a clear tutorial. To address these problems, we present the GUIDE (Guideline-Guided) dataset, which contains 3.5K videos of 560 instructional tasks in 8 domains related to our daily life. Specifically, we annotate each instructional task with a guideline, representing a common pattern shared by all task-related videos. On this basis, we annotate systematic specific steps, including their associated guideline steps, specific step descriptions and timestamps. Our proposed benchmark consists of three sub-tasks to evaluate comprehension ability of models: (1) Step Captioning: models have to generate captions for specific steps from videos. (2) Guideline Summarization: models have to mine the common pattern in task-related videos and summarize a guideline from them. (3) Guideline-Guided Captioning: models have to generate captions for specific steps under the guide of guideline. We evaluate plenty of foundation models with GUIDE and perform in-depth analysis. Given the diversity and practicality of GUIDE, we believe that it can be used as a better benchmark for instructional video comprehension.

Grammatical error correction (GEC) aims to improve quality and readability of texts through accurate correction of linguistic mistakes. Previous work has focused on high-resource languages, while low-resource languages lack robust tools. However, low-resource languages often face problems such as: non-standard orthography, limited annotated corpora, and diverse dialects, which slows down the development of GEC tools. We present a study on GEC for Zarma, spoken by over five million in West Africa. We compare three approaches: rule-based methods, machine translation (MT) models, and large language models (LLMs). We evaluated them using a dataset of more than 250,000 examples, including synthetic and human-annotated data. Our results showed that the MT-based approach using M2M100 outperforms others, with a detection rate of 95. 82% and a suggestion accuracy of 78. 90% in automatic evaluations (AE) and an average score of 3.0 out of 5.0 in manual evaluation (ME) from native speakers for grammar and logical corrections. The rule-based method was effective for spelling errors but failed on complex context-level errors. LLMs -- MT5-small -- showed moderate performance. Our work supports use of MT models to enhance GEC in low-resource settings, and we validated these results with Bambara, another West African language.

Specialized clinical AI assistants are rapidly entering medical practice, often framed as safer or more reliable than general-purpose large language models (LLMs). Yet, unlike frontier models, these clinical tools are rarely subjected to independent, quantitative evaluation, creating a critical evidence gap despite their growing influence on diagnosis, triage, and guideline interpretation. We assessed two widely deployed clinical AI systems (OpenEvidence and UpToDate Expert AI) against three state-of-the-art generalist LLMs (GPT-5, Gemini 3 Pro, and Claude Sonnet 4.5) using a 1,000-item mini-benchmark combining MedQA (medical knowledge) and HealthBench (clinician-alignment) tasks. Generalist models consistently outperformed clinical tools, with GPT-5 achieving the highest scores, while OpenEvidence and UpToDate demonstrated deficits in completeness, communication quality, context awareness, and systems-based safety reasoning. These findings reveal that tools marketed for clinical decision support may often lag behind frontier LLMs, underscoring the urgent need for transparent, independent evaluation before deployment in patient-facing workflows.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

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

This paper presents CG-Eval, the first comprehensive evaluation of the generation capabilities of large Chinese language models across a wide range of academic disciplines. The models' performance was assessed based on their ability to generate accurate and relevant responses to different types of questions in six disciplines, namely, Science and Engineering, Humanities and Social Sciences, Mathematical Calculations, Medical Practitioner Qualification Examination, Judicial Examination, and Certified Public Accountant Examination. This paper also presents Gscore, a composite index derived from the weighted sum of multiple metrics to measure the quality of model's generation against a reference. The test data and test results can be found at http://cgeval.besteasy.com/.

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

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

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

Do LLMs robustly generalize critical safety facts to novel situations? Lacking this ability is dangerous when users ask naive questions. For instance, "I'm considering packing melon balls for my 10-month-old's lunch. What other foods would be good to include?" Before offering food options, the LLM should warn that melon balls pose a choking hazard to toddlers, as documented by the CDC. Failing to provide such warnings could result in serious injuries or even death. To evaluate this, we introduce SAGE-Eval, SAfety-fact systematic GEneralization evaluation, the first benchmark that tests whether LLMs properly apply well established safety facts to naive user queries. SAGE-Eval comprises 104 facts manually sourced from reputable organizations, systematically augmented to create 10,428 test scenarios across 7 common domains (e.g., Outdoor Activities, Medicine). We find that the top model, Claude-3.7-sonnet, passes only 58% of all the safety facts tested. We also observe that model capabilities and training compute weakly correlate with performance on SAGE-Eval, implying that scaling up is not the golden solution. Our findings suggest frontier LLMs still lack robust generalization ability. We recommend developers use SAGE-Eval in pre-deployment evaluations to assess model reliability in addressing salient risks. We publicly release SAGE-Eval at https://huggingface.co/datasets/YuehHanChen/SAGE-Eval and our code is available at https://github.com/YuehHanChen/SAGE-Eval/tree/main.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Systematic literature review is essential for evidence-based medicine, requiring comprehensive analysis of clinical trial publications. However, the application of artificial intelligence (AI) models for medical literature mining has been limited by insufficient training and evaluation across broad therapeutic areas and diverse tasks. Here, we present LEADS, an AI foundation model for study search, screening, and data extraction from medical literature. The model is trained on 633,759 instruction data points in LEADSInstruct, curated from 21,335 systematic reviews, 453,625 clinical trial publications, and 27,015 clinical trial registries. We showed that LEADS demonstrates consistent improvements over four cutting-edge generic large language models (LLMs) on six tasks. Furthermore, LEADS enhances expert workflows by providing supportive references following expert requests, streamlining processes while maintaining high-quality results. A study with 16 clinicians and medical researchers from 14 different institutions revealed that experts collaborating with LEADS achieved a recall of 0.81 compared to 0.77 experts working alone in study selection, with a time savings of 22.6%. In data extraction tasks, experts using LEADS achieved an accuracy of 0.85 versus 0.80 without using LEADS, alongside a 26.9% time savings. These findings highlight the potential of specialized medical literature foundation models to outperform generic models, delivering significant quality and efficiency benefits when integrated into expert workflows for medical literature mining.

In the age of open and free information, a concerning trend of reliance on AI is emerging. However, existing AI tools struggle to evaluate the credibility of information and to justify their assessments. Hence, there is a growing need for systems that can help users evaluate the trustworthiness of online information. Although major search engines incorporate AI features, they often lack clear reliability indicators. We present TrueGL, a model that makes trustworthy search results more accessible. The model is a fine-tuned version of IBM's Granite-1B, trained on the custom dataset and integrated into a search engine with a reliability scoring system. We evaluate the system using prompt engineering and assigning each statement a continuous reliability score from 0.1 to 1, then instructing the model to return a textual explanation alongside the score. Each model's predicted scores are measured against real scores using standard evaluation metrics. TrueGL consistently outperforms other small-scale LLMs and rule-based approaches across all experiments on key evaluation metrics, including MAE, RMSE, and R2. The model's high accuracy, broad content coverage, and ease of use make trustworthy information more accessible and help reduce the spread of false or misleading content online. Our code is publicly available at https://github.com/AlgazinovAleksandr/TrueGL, and our model is publicly released at https://huggingface.co/JoydeepC/trueGL.

While Group Relative Policy Optimization (GRPO) offers a powerful framework for LLM post-training, its effectiveness in open-ended domains like Machine Translation hinges on accurate intra-group ranking. We identify that standard Scalar Quality Metrics (SQM) fall short in this context; by evaluating candidates in isolation, they lack the comparative context necessary to distinguish fine-grained linguistic nuances. To address this, we introduce the Group Quality Metric (GQM) paradigm and instantiate it via the Group Relative Reward Model (GRRM). Unlike traditional independent scorers, GRRM processes the entire candidate group jointly, leveraging comparative analysis to rigorously resolve relative quality and adaptive granularity. Empirical evaluations confirm that GRRM achieves competitive ranking accuracy among all baselines. Building on this foundation, we integrate GRRM into the GRPO training loop to optimize the translation policy. Experimental results demonstrate that our framework not only improves general translation quality but also unlocks reasoning capabilities comparable to state-of-the-art reasoning models. We release codes, datasets, and model checkpoints at https://github.com/NJUNLP/GRRM.