Sarah Montgomery-Taylor, Hamsa Subramaniam, Rob Brisk, Liam Foster, Jack Ching, Andrew Marshall, Jim Taylor, John Hernandez 等 32 位作者
General-purpose generative AI (GenAI) models are being rapidly adopted in healthcare, but they are challenging to assess with traditional evaluation frameworks. These conceptual, methodological, and practical challenges parallel decades of work in evaluating clinician and health system quality and safety. We describe the adaptation of methods from several fields, combined with emerging technical approaches, into a structured, multi-method evaluation framework designed to give well-rounded assessments of GenAI in health at scale. The approach first anchors evaluation to Critical User Journeys (CUJs) to help prioritize out of a large choice space, and maps these to a phased AI system lifecycle (base model development, product development, and post-deployment monitoring), since evaluation at each stage requires different methodological approaches. In this context, the approach then integrates three distinct evaluation methods (closed-question benchmarks, LLM-as-a-judge autoraters, and expert human review) across three core domains: accuracy, safety, and usefulness. Taken together, this approach provides a strategic framework for bridging the gap between benchmarking results and performance in the real world with the goal of supporting decision-making and accountability across development, procurement, and deployment for product teams, health systems, and regulators.
Training language models in simulation for psychiatric intake
Samuel Schmidgall, Tim Strother, Alex Bijamov, Min Woo Sun, Anil Palepu, Akshay Goel, Ulysse Marteau-Ferey, Théo Moutakanni 等 56 位作者
AI 速览：作者报告，在模拟环境中进行多轮强化学习训练，可提升语言模型在结构化精神科接诊中的表现，包括病史采集、鉴别诊断和初始管理计划。
In psychiatric practice, the clinical intake interview remains a primary diagnostic instrument, requiring the clinician to establish rapport while disentangling complex, overlapping presentations. Here, we show that multi-turn reinforcement learning (RL) in simulation environments improves language model performance on structured text-based psychiatric intake, spanning history-taking, differential diagnosis, and initial management planning. In a randomized, double-blind crossover study ($N = 60$ matched scenario pairs, 120 encounters) comparing the RL-trained agent against its identically prompted base model, 32 board-certified psychiatrists role-played standardized patients while a separate panel of 15 independent, board-certified psychiatrists scored the de-identified transcripts. The trained agent outperformed the base model in 76.7% of matched scenario pairs ($p < 0.0001$), with gains on an adapted clinical-examination rubric ($d_z = 0.77$, $p < 0.0001$), patient-centered communication (82.0% vs. 65.2%, $p < 0.001$), and differential diagnosis appropriateness (68.3% vs. 33.3%, $p < 0.001$). Across 127 psychiatrist-validated simulated intake scenarios, the trained agent nearly doubled its base model's clinical rubric score (0.706 vs. 0.379; composite reward 0.564 vs. 0.294, $p < 0.0001$). To systematically probe conversational safety, we established two Delphi-consensus taxonomies, of clinical safety risks and relational competencies, from which 256 challenging adversarial presentations were derived; we find that training in simulation environments more than halved under-triage of acute safety risks (12.9% vs. 30.5%, $p < 0.0001$). Simulation environments thus provide a controlled testbed for training and stress-testing psychiatric conversational agents, with gains that transferred to psychiatrist-enacted encounters, though residual gaps require safeguards and clinician oversight.
Chi Ruan, Tianqi Li, Xin He, Xue Geng, Ming-Ming Cheng, Yun Liu
Camouflaged object detection (COD) depends on weak texture and boundary cues that can be destroyed by aggressive post-training quantization (PTQ). Existing PTQ methods mainly optimize quantizers or reconstruct network blocks, while using a single precision-allocation domain throughout hierarchical backbones. Instead, we introduce AxisQ, a depth-adaptive bit-allocation framework motivated by the observation that the useful allocation axis changes with feature depth. Under a fixed per-layer average activation-bit budget, AxisQ allocates precision in the channel domain for shallow features and in the local-frequency domain for deep features, using COD-aware sensitivity to better preserve subtle foreground regions and ambiguous boundaries. We also formulate a boundary-aware Hessian approximation for reconstruction by incorporating boundary-weighted gradient and error statistics. Experiments across multiple COD models and diverse benchmarks demonstrate improved accuracy over the strongest baselines at low bit widths, with relative weighted F-measure gains of 12.7% for CFRN and 33.3% for CamoFormer-P on CAMO under W2A2 quantization. These results support adapting the allocation domain to feature depth as a transferable quantization strategy for hierarchical COD models.
Qingyun Liu, Bo Yan, Yang Liu, Yuji Roh, Ekansh Sharma, Likang Yin, Emma Olowo, Yuxuan Li 等 19 位作者
User modeling in industrial recommender systems typically produces dense embeddings, which suffer from representational constraints due to fixed-dimensional vectors. As an emerging alternative for discrete user representation, LLM-generated natural-language user profiles often capture language semantics rather than sequential patterns in user behaviors. Meanwhile, Semantic ID (SID) is effective for item representation, yet existing discrete user representations remain largely confined to quantizing already-pooled user vectors, clustering historical watches, or predicting coarse topic clusters solely for candidate retrieval. We propose TokenMinds, an industrial system that extends the PLUM framework from SID-based item retrieval to generative sequential user modeling. Built on an encoder-decoder architecture adapted from pretrained LLMs, TokenMinds introduces a dual-output design: the encoder outputs a dense user embedding capturing a holistic user state, while the decoder generates discrete SID-based user tokens representing multi-faceted future interests. Grounded in item semantics, these tokens preserve distinct interests that a single pooled vector would average away. Additionally, a shared SID vocabulary across long- and short-form videos unifies cross-scenario behaviors into a single model, cutting upstream training and serving compute by 50% and 31%. Furthermore, leveraging the text vocabulary inherited from the pretrained LLM, TokenMinds interleaves textual search queries directly with watch histories to capture explicit user intent. We validate TokenMinds through offline evaluations and live A/B experiments across YouTube's primary ranking surfaces, serving billions of users asynchronously: SID-based user tokens are effective on their own, yield additive gains alongside dense embeddings, and together outperform the previous-generation, non-LLM user model in production.
Planetary Geospatial Foundation Models: A New Paradigm for Global Public Health
Arbaaz Muslim, Aviv Slobodkin, Katherine Wheeler-Martin, Eric Zhou, John Brittain, Martin Frasch, Hamsa Subramaniam, Jacob Bien 等 38 位作者
AI 速览：提出并展示地理空间基础模型 PDFM 如何以可泛化的地点表征补充传统流行病学工作流，并在多国多任务案例中改善公共卫生监测。
The efficacy of traditional disease prediction is limited by spatial gaps and temporal lags, which impact the timing and targets of resource deployments. Outbreaks escalate undetected, chronic disease burdens are quantified years later, and at-risk populations in data-sparse regions remain unaddressed. Planetary geospatial foundation models complement existing epidemiological workflows to provide operational improvements, encoding multimodal search, mobility, and environmental signals into generalizable place representations. As illustrations of this complementarity, we present independent global health case studies of Google Earth AI's Population Dynamics Foundation Model (PDFM) -- a foundation model for geospatial inference -- across four domains (vaccine-preventable, communicable, noncommunicable, maternal mental health), five tasks (spatial extrapolation, interpolation/nowcasting, probabilistic forecasting, prospective forecasting, risk stratification), and four countries (USA, Canada, Mexico, and the Democratic Republic of the Congo). Across these case studies, PDFM addresses critical surveillance gaps across domains: improving US-Canada border MMR vaccination coverage predictions by capturing cross-border behavioral spillovers domestic models miss; nowcasting cardiovascular disease to accelerate data availability; enhancing short-term municipal Mexican dengue forecasts for timely outbreak vector control; improving forecasts of cholera hotspots; and adding a transferable signal to individual-level postpartum-depression risk prediction in US states the model had never seen, while not replacing individual socioeconomic data or closing demographic screening gaps. Together, these results showcase capabilities of geospatial foundation models for public health surveillance.
Girish Narayanswamy, Maxwell A. Xu, A. Ali Heydari, Samy Abdel-Ghaffar, Marius Guerard, Kara Vaillancourt, Zhihan Zhang, Jake Garrison 等 40 位作者
While ubiquitous wearable sensors capture a wealth of behavioral and physiological information, effectively transforming these signals into personalized health insights is challenging. Specifically, converting low-level sensor data into representations capable of characterizing higher-level states is difficult due to high phenotypic diversity and variation in individual baseline health, physiology, and lifestyle factors. Moreover, collecting wearable data paired with health outcome annotations is laborious and expensive, and retrospective annotation remains practically unfeasible, contributing to a scarcity of data with high-quality labels. To overcome these limitations, we propose a foundation model for wearable health that is pretrained on more than one trillion minutes of unlabeled sensor signals drawn from a large cohort of five million participants. We demonstrate that the joint scaling of model capacity and pretraining data volume leads to systematic improvements in performance, as evaluated on a diverse set of 35 health prediction tasks, spanning cardiovascular, metabolic, sleep, and mental health, as well as lifestyle choices and demographic factors. We find that this population scale representation unlocks label-efficient few-shot learning and generative capabilities for robust daily metric estimation. To further leverage this learned representation, we deploy a classroom of LLM agents to autonomously search the space of downstream predictive heads built on the model embeddings, showing broad performance improvements that increase with LLM model capacity. Finally, we show how integrating these downstream predictors into a Personal Health Agent can support model responses that are more relevant, contextually aware, and safe, and we validate this via 1,860 ratings from a cohort of clinicians.
Yida Cai Tsinghua University, Ranjuexiao Hu, Huiyuan Xie, Chenyang Li, Yun Liu, Yuxiao Ye, Zhenghao Liu Northeastern University, Weixing Shen 等 9 位作者
Legal relations serve as an important analytical framework for dispute resolution in civil cases. However, legal relations in Chinese civil cases remain underexplored in the field of legal AI, largely due to the absence of comprehensive schemas. In this work, we first introduce a comprehensive schema for legal relations in civil cases, which contains a hierarchical taxonomy and definitions of arguments. Based on this schema, we formulate a legal relation extraction task and present LexRel, an expert-annotated benchmark for legal relation extraction in the Chinese civil law domain. We use LexRel to evaluate state-of-the-art large language models (LLMs) on legal relation extraction, showing that current LLMs exhibit significant limitations in accurately identifying civil legal relations. Furthermore, we demonstrate that explicitly incorporating information about legal relations leads to promising performance gains on other downstream legal AI tasks.
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cs.CL
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers) · 2026 · 正式发表
Rory Sayres, Kejia Chen, Ayush Jain, Matthew Thompson, Jonathan Richina, Xiang Yin, Jimmy Hu, Fan Zhang 等 22 位作者
Patient-managed Personal Health Records (PHRs) promises to empower patients to better understand their health; but information in the record is complex, potentially hindering insights. In this study, we assess the potential of large language models (LLMs, Gemini 3.0 Flash) to provide helpful answers to user health queries, when provided clinical data from PHRs as context. A total of 2,257 user queries were drawn from 3 different distributions to represent patient questions: shorter web search queries, longer questions derived from templates of chatbot conversations, and questions patients asked to their healthcare team (patient calls). Queries were matched with de-identified PHRs (from a pool of 1,945). Gemini responses were generated (1) without PHR context; (2) with a basic summary of demographics, conditions, and medications; (3) with full, extensive clinical notes. For evaluation, we leveraged an existing rating framework (SHARP), and developed a new framework for specific error modes when interpreting PHRs. Evaluation was performed using autoraters for the full set, and with clinician ratings for a subset (n=95), with both sets of raters knowing the full PHR context. We see significant improvements in the helpfulness of answers to all question types with PHR data (p < 0.001, paired t-test). We also observe potential gains in safety, accuracy, relevance and personalization of answers. Our PHR evaluation framework further identifies gaps in LLM understanding of particular aspects of complex PHRs, such as temporal disorientation, and rare but meaningful confabulations. These results suggest potential for PHR data to help people with a wide range of user needs; and provide a framework for monitoring for gaps in LLM answers based on PHR context. This study motivates further work to assess and realize potential benefits to users from understanding their health records.
Joseph Breda, Fadi Yousif, Beszel Hawkins, Marinela Cotoi, Miao Liu, Ray Luo, Po-Hsuan Cameron Chen, Mike Schaekermann 等 33 位作者
Language models excel at diagnostic assessments on curated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.56, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.
Yubin Kim, Ken Gu, Chanwoo Park, Chunjong Park, Samuel Schmidgall, A. Ali Heydari, Yao Yan, Zhihan Zhang 等 20 位作者
Agents, language model-based systems capable of reasoning, planning, and acting are widely adopted in real-world tasks, yet how their performance changes as these systems scale across key dimensions remains underexplored. We introduce quantitative scaling principles for agent systems as a predictive model, capturing how performance varies with coordination, model capability, and measurable system and task factors. Across 260 configurations spanning six agentic benchmarks, five canonical architectures (Single-Agent and four Multi-Agent: Independent, Centralized, Decentralized, Hybrid), and three LLM families, we perform controlled evaluations, standardizing tools, prompts, and compute to isolate architectural effects. The resulting model achieves a cross-validated R^2=0.373 across all six benchmarks (R^2=0.413 with a task-grounded capability metric). We identify a robust capability-saturation effect and additional patterns: (1) a coordination yields diminishing returns once single-agent baselines exceed certain performance; (2) tool-heavy tasks appear to incur multi-agent overhead; and (3) architectures without centralized verification tend to propagate errors more than those with centralized coordination. Relative performance change compared to single-agent baseline ranges from +80.8% on decomposable financial reasoning to -70.0% on sequential planning, demonstrating that architecture-task alignment determines collaborative success. The framework identifies the best-performing architecture for 87% of held-out configurations and shows consistent relative architecture preferences on unseen frontier models. Agent effectiveness depends on alignment between coordination and task structure, and that mismatched coordination degrades the performance.
Andrew Sellergren, Sahar Kazemzadeh, Tiam Jaroensri, Atilla Kiraly, Madeleine Traverse, Timo Kohlberger, Shawn Xu, Fayaz Jamil 等 81 位作者
Artificial intelligence (AI) has significant potential in healthcare applications, but its training and deployment faces challenges due to healthcare's diverse data, complex tasks, and the need to preserve privacy. Foundation models that perform well on medical tasks and require less task-specific tuning data are critical to accelerate the development of healthcare AI applications. We introduce MedGemma, a collection of medical vision-language foundation models based on Gemma 3 4B and 27B. MedGemma demonstrates advanced medical understanding and reasoning on images and text, significantly exceeding the performance of similar-sized generative models and approaching the performance of task-specific models, while maintaining the general capabilities of the Gemma 3 base models. For out-of-distribution tasks, MedGemma achieves 2.6-10% improvement on medical multimodal question answering, 15.5-18.1% improvement on chest X-ray finding classification, and 10.8% improvement on agentic evaluations compared to the base models. Fine-tuning MedGemma further improves performance in subdomains, reducing errors in electronic health record information retrieval by 50% and reaching comparable performance to existing specialized state-of-the-art methods for pneumothorax classification and histopathology patch classification. We additionally introduce MedSigLIP, a medically-tuned vision encoder derived from SigLIP. MedSigLIP powers the visual understanding capabilities of MedGemma and as an encoder achieves comparable or better performance than specialized medical image encoders. Taken together, the MedGemma collection provides a strong foundation of medical image and text capabilities, with potential to significantly accelerate medical research and development of downstream applications. The MedGemma collection, including tutorials and model weights, can be found at https://goo.gle/medgemma.
AI 速览：提出人口动态基础模型（PDFM），通过图神经网络融合多源地理数据生成嵌入，在27个地理空间任务上取得领先表现。
Supporting the health and well-being of dynamic populations around the world requires governmental agencies, organizations and researchers to understand and reason over complex relationships between human behavior and local contexts in order to identify high-risk groups and strategically allocate limited resources. Traditional approaches to these classes of problems often entail developing manually curated, task-specific features and models to represent human behavior and the natural and built environment, which can be challenging to adapt to new, or even, related tasks. To address this, we introduce a Population Dynamics Foundation Model (PDFM) that aims to capture the relationships between diverse data modalities and is applicable to a broad range of geospatial tasks. We first construct a geo-indexed dataset for postal codes and counties across the United States, capturing rich aggregated information on human behavior from maps, busyness, and aggregated search trends, and environmental factors such as weather and air quality. We then model this data and the complex relationships between locations using a graph neural network, producing embeddings that can be adapted to a wide range of downstream tasks using relatively simple models. We evaluate the effectiveness of our approach by benchmarking it on 27 downstream tasks spanning three distinct domains: health indicators, socioeconomic factors, and environmental measurements. The approach achieves state-of-the-art performance on all 27 geospatial interpolation tasks, and on 25 out of the 27 extrapolation and super-resolution tasks. We combined the PDFM with a state-of-the-art forecasting foundation model, TimesFM, to predict unemployment and poverty, achieving performance that surpasses fully supervised forecasting. The full set of embeddings and sample code are publicly available for researchers.
Peter Brodeur, Jacob M. Koshy, Anil Palepu, Khaled Saab, Ava Homiar, Roma Ruparel, Charles Wu, Ryutaro Tanno 等 48 位作者
Large language model (LLM)-based AI systems have shown promise for patient-facing diagnostic and management conversations in simulated settings. Translating these systems into clinical practice requires assessment in real-world workflows with rigorous safety oversight. We report a prospective, single-arm feasibility study of an LLM-based conversational AI, the Articulate Medical Intelligence Explorer (AMIE), conducting clinical history taking and presentation of potential diagnoses for patients to discuss with their provider at urgent care appointments at a leading academic medical center. 100 adult patients completed an AMIE text-chat interaction up to 5 days before their appointment. We sought to assess the conversational safety and quality, patient and clinician experience, and clinical reasoning capabilities compared to primary care providers (PCPs). Human safety supervisors monitored all patient-AMIE interactions in real time and did not need to intervene to stop any consultations based on pre-defined criteria. Patients reported high satisfaction and their attitudes towards AI improved after interacting with AMIE (p < 0.001). PCPs found AMIE's output useful with a positive impact on preparedness. AMIE's differential diagnosis (DDx) included the final diagnosis, per chart review 8 weeks post-encounter, in 90% of cases, with 75% top-3 accuracy. Blinded assessment of AMIE and PCP DDx and management (Mx) plans suggested similar overall DDx and Mx plan quality, without significant differences for DDx (p = 0.6) and appropriateness and safety of Mx (p = 0.1 and 1.0, respectively). PCPs outperformed AMIE in the practicality (p = 0.003) and cost effectiveness (p = 0.004) of Mx. While further research is needed, this study demonstrates the initial feasibility, safety, and user acceptance of conversational AI in a real-world setting, representing crucial steps towards clinical translation.