Daily Papers

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

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.

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.

Large language models, trained on extensive corpora, successfully unify diverse linguistic tasks within a single generative framework. Inspired by this, recent works like Large Vision Model (LVM) extend this paradigm to vision by organizing tasks into sequential visual sentences, where visual prompts serve as the context to guide outputs. However, such modeling requires task-specific pre-training across modalities and sources, which is costly and limits scalability to unseen tasks. Given that pre-trained video generation models inherently capture temporal sequence dependencies, we explore a more unified and scalable alternative: can a pre-trained video generation model adapt to diverse image and video tasks? To answer this, we propose UniVid, a framework that fine-tunes a video diffusion transformer to handle various vision tasks without task-specific modifications. Tasks are represented as visual sentences, where the context sequence defines both the task and the expected output modality. We evaluate the generalization of UniVid from two perspectives: (1) cross-modal inference with contexts composed of both images and videos, extending beyond LVM's uni-modal setting; (2) cross-source tasks from natural to annotated data, without multi-source pre-training. Despite being trained solely on natural video data, UniVid generalizes well in both settings. Notably, understanding and generation tasks can easily switch by simply reversing the visual sentence order in this paradigm. These findings highlight the potential of pre-trained video generation models to serve as a scalable and unified foundation for vision modeling. Our code will be released at https://github.com/CUC-MIPG/UniVid.

The rapid progress of Large Multimodal Models (LMMs) and cloud-based AI agents is transforming human-AI collaboration into bidirectional, multimodal interaction. However, existing codecs remain optimized for unimodal, one-way communication, resulting in repeated degradation under conventional compress-transmit-reconstruct pipelines. To address this limitation, we propose UniMIC, a Unified token-based Multimodal Interactive Coding framework that bridges edge devices and cloud AI agents. Instead of transmitting raw pixels or plain text, UniMIC employs compact tokenized representations as the communication medium, enabling efficient low-bitrate transmission while maintaining compatibility with LMMs. To further enhance compression, lightweight Transformer-based entropy models with scenario-specific designs-generic, masked, and text-conditioned-effectively minimize inter-token redundancy. Extensive experiments on text-to-image generation, text-guided inpainting, outpainting, and visual question answering show that UniMIC achieves substantial bitrate savings and remains robust even at ultra-low bitrates (<0.05bpp), without compromising downstream task performance. These results establish UniMIC as a practical and forward-looking paradigm for next-generation multimodal interactive communication.