Daily Papers

This paper explores in-context learning for image copy detection (ICD), i.e., prompting an ICD model to identify replicated images with new tampering patterns without the need for additional training. The prompts (or the contexts) are from a small set of image-replica pairs that reflect the new patterns and are used at inference time. Such in-context ICD has good realistic value, because it requires no fine-tuning and thus facilitates fast reaction against the emergence of unseen patterns. To accommodate the "seen rightarrow unseen" generalization scenario, we construct the first large-scale pattern dataset named AnyPattern, which has the largest number of tamper patterns (90 for training and 10 for testing) among all the existing ones. We benchmark AnyPattern with popular ICD methods and reveal that existing methods barely generalize to novel tamper patterns. We further propose a simple in-context ICD method named ImageStacker. ImageStacker learns to select the most representative image-replica pairs and employs them as the pattern prompts in a stacking manner (rather than the popular concatenation manner). Experimental results show (1) training with our large-scale dataset substantially benefits pattern generalization (+26.66 % mu AP), (2) the proposed ImageStacker facilitates effective in-context ICD (another round of +16.75 % mu AP), and (3) AnyPattern enables in-context ICD, i.e. without such a large-scale dataset, in-context learning does not emerge even with our ImageStacker. The project (including the proposed dataset AnyPattern and the code for ImageStacker) is publicly available at https://anypattern.github.io under the MIT Licence.

Recently, In-context Learning (ICL) has become a significant inference paradigm in Large Multimodal Models (LMMs), utilizing a few in-context demonstrations (ICDs) to prompt LMMs for new tasks. However, the synergistic effects in multimodal data increase the sensitivity of ICL performance to the configurations of ICDs, stimulating the need for a more stable and general mapping function. Mathematically, in Transformer-based models, ICDs act as ``shift vectors'' added to the hidden states of query tokens. Inspired by this, we introduce Mimic In-Context Learning (MimIC) to learn stable and generalizable shift effects from ICDs. Specifically, compared with some previous shift vector-based methods, MimIC more strictly approximates the shift effects by integrating lightweight learnable modules into LMMs with four key enhancements: 1) inserting shift vectors after attention layers, 2) assigning a shift vector to each attention head, 3) making shift magnitude query-dependent, and 4) employing a layer-wise alignment loss. Extensive experiments on two LMMs (Idefics-9b and Idefics2-8b-base) across three multimodal tasks (VQAv2, OK-VQA, Captioning) demonstrate that MimIC outperforms existing shift vector-based methods. The code is available at https://github.com/Kamichanw/MimIC.

As language models continue to scale, Large Language Models (LLMs) have exhibited emerging capabilities in In-Context Learning (ICL), enabling them to solve language tasks by prefixing a few in-context demonstrations (ICDs) as context. Inspired by these advancements, researchers have extended these techniques to develop Large Multimodal Models (LMMs) with ICL capabilities. However, existing LMMs face a critical issue: they often fail to effectively leverage the visual context in multimodal demonstrations and instead simply follow textual patterns. This indicates that LMMs do not achieve effective alignment between multimodal demonstrations and model outputs. To address this problem, we propose Symbol Demonstration Direct Preference Optimization (SymDPO). Specifically, SymDPO aims to break the traditional paradigm of constructing multimodal demonstrations by using random symbols to replace text answers within instances. This forces the model to carefully understand the demonstration images and establish a relationship between the images and the symbols to answer questions correctly. We validate the effectiveness of this method on multiple benchmarks, demonstrating that with SymDPO, LMMs can more effectively understand the multimodal context within examples and utilize this knowledge to answer questions better.

Large Language Models (LLMs) have shown remarkable success in various tasks, but concerns about their safety and the potential for generating malicious content have emerged. In this paper, we explore the power of In-Context Learning (ICL) in manipulating the alignment ability of LLMs. We find that by providing just few in-context demonstrations without fine-tuning, LLMs can be manipulated to increase or decrease the probability of jailbreaking, i.e. answering malicious prompts. Based on these observations, we propose In-Context Attack (ICA) and In-Context Defense (ICD) methods for jailbreaking and guarding aligned language model purposes. ICA crafts malicious contexts to guide models in generating harmful outputs, while ICD enhances model robustness by demonstrations of rejecting to answer harmful prompts. Our experiments show the effectiveness of ICA and ICD in increasing or reducing the success rate of adversarial jailbreaking attacks. Overall, we shed light on the potential of ICL to influence LLM behavior and provide a new perspective for enhancing the safety and alignment of LLMs.

Large Language Models (LLMs) rely on Human Preference Alignment (HPA) to ensure the generation of safe content. Due to the heavy cost associated with fine-tuning, fine-tuning-free methods have emerged, typically modifying LLM decoding with external auxiliary methods. However, these methods do not essentially enhance the LLM itself. In this paper, we rethink the derivation procedures of DPO, based on which we conversely build an instant scorer using the states of the LLM before and after In-context Learning (ICL). Accordingly, we propose a novel approach called In-Context Direct Preference Optimization (ICDPO). It enables LLMs to borrow the HPA capabilities from superior LLMs with ICL, generating well-aligned responses as estimated by the aforementioned instant scorer, thereby enhancing the final performance. ICDPO can be further enhanced with a two-stage retriever and an upgraded scorer, both offering benefits. Extensive experiments show its effectiveness, particularly in outperforming two fine-tuning-free baselines, and it exhibits competitiveness with SFT + LoRA. We also conduct detailed analyses to offer comprehensive insights into ICDPO.

The increasing use of tools and solutions based on Large Language Models (LLMs) for various tasks in the medical domain has become a prominent trend. Their use in this highly critical and sensitive domain has thus raised important questions about their robustness, especially in response to variations in input, and the reliability of the generated outputs. This study addresses these questions by constructing a textual dataset based on the ICD-10-CM code descriptions, widely used in US hospitals and containing many clinical terms, and their easily reproducible rephrasing. We then benchmarked existing embedding models, either generalist or specialized in the clinical domain, in a semantic search task where the goal was to correctly match the rephrased text to the original description. Our results showed that generalist models performed better than clinical models, suggesting that existing clinical specialized models are more sensitive to small changes in input that confuse them. The highlighted problem of specialized models may be due to the fact that they have not been trained on sufficient data, and in particular on datasets that are not diverse enough to have a reliable global language understanding, which is still necessary for accurate handling of medical documents.

Automatic coding of International Classification of Diseases (ICD) is a multi-label text categorization task that involves extracting disease or procedure codes from clinical notes. Despite the application of state-of-the-art natural language processing (NLP) techniques, there are still challenges including limited availability of data due to privacy constraints and the high variability of clinical notes caused by different writing habits of medical professionals and various pathological features of patients. In this work, we investigate the semi-structured nature of clinical notes and propose an automatic algorithm to segment them into sections. To address the variability issues in existing ICD coding models with limited data, we introduce a contrastive pre-training approach on sections using a soft multi-label similarity metric based on tree edit distance. Additionally, we design a masked section training strategy to enable ICD coding models to locate sections related to ICD codes. Extensive experimental results demonstrate that our proposed training strategies effectively enhance the performance of existing ICD coding methods.

The high computational cost and slow inference time are major obstacles to deploying the video diffusion model (VDM) in practical applications. To overcome this, we introduce a new Video Diffusion Model Compression approach using individual content and motion dynamics preserved pruning and consistency loss. First, we empirically observe that deeper VDM layers are crucial for maintaining the quality of motion dynamics e.g., coherence of the entire video, while shallower layers are more focused on individual content e.g., individual frames. Therefore, we prune redundant blocks from the shallower layers while preserving more of the deeper layers, resulting in a lightweight VDM variant called VDMini. Additionally, we propose an Individual Content and Motion Dynamics (ICMD) Consistency Loss to gain comparable generation performance as larger VDM, i.e., the teacher to VDMini i.e., the student. Particularly, we first use the Individual Content Distillation (ICD) Loss to ensure consistency in the features of each generated frame between the teacher and student models. Next, we introduce a Multi-frame Content Adversarial (MCA) Loss to enhance the motion dynamics across the generated video as a whole. This method significantly accelerates inference time while maintaining high-quality video generation. Extensive experiments demonstrate the effectiveness of our VDMini on two important video generation tasks, Text-to-Video (T2V) and Image-to-Video (I2V), where we respectively achieve an average 2.5 times and 1.4 times speed up for the I2V method SF-V and the T2V method T2V-Turbo-v2, while maintaining the quality of the generated videos on two benchmarks, i.e., UCF101 and VBench.

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.

Codification of free-text clinical narratives have long been recognised to be beneficial for secondary uses such as funding, insurance claim processing and research. The current scenario of assigning codes is a manual process which is very expensive, time-consuming and error prone. In recent years, many researchers have studied the use of Natural Language Processing (NLP), related Machine Learning (ML) and Deep Learning (DL) methods and techniques to resolve the problem of manual coding of clinical narratives and to assist human coders to assign clinical codes more accurately and efficiently. This systematic literature review provides a comprehensive overview of automated clinical coding systems that utilises appropriate NLP, ML and DL methods and techniques to assign ICD codes to discharge summaries. We have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines and conducted a comprehensive search of publications from January, 2010 to December 2020 in four academic databases- PubMed, ScienceDirect, Association for Computing Machinery(ACM) Digital Library, and the Association for Computational Linguistics(ACL) Anthology. We reviewed 7,556 publications; 38 met the inclusion criteria. This review identified: datasets having discharge summaries; NLP techniques along with some other data extraction processes, different feature extraction and embedding techniques. To measure the performance of classification methods, different evaluation metrics are used. Lastly, future research directions are provided to scholars who are interested in automated ICD code assignment. Efforts are still required to improve ICD code prediction accuracy, availability of large-scale de-identified clinical corpora with the latest version of the classification system. This can be a platform to guide and share knowledge with the less experienced coders and researchers.

With the increasing ability of large language models (LLMs), in-context learning (ICL) has become a new paradigm for natural language processing (NLP), where LLMs make predictions only based on contexts augmented with a few examples. It has been a new trend to explore ICL to evaluate and extrapolate the ability of LLMs. In this paper, we aim to survey and summarize the progress and challenges of ICL. We first present a formal definition of ICL and clarify its correlation to related studies. Then, we organize and discuss advanced techniques, including training strategies, demonstration designing strategies, as well as related analysis. Finally, we discuss the challenges of ICL and provide potential directions for further research. We hope that our work can encourage more research on uncovering how ICL works and improving ICL.

This study investigates the feasibility of automating clinical coding in Russian, a language with limited biomedical resources. We present a new dataset for ICD coding, which includes diagnosis fields from electronic health records (EHRs) annotated with over 10,000 entities and more than 1,500 unique ICD codes. This dataset serves as a benchmark for several state-of-the-art models, including BERT, LLaMA with LoRA, and RAG, with additional experiments examining transfer learning across domains (from PubMed abstracts to medical diagnosis) and terminologies (from UMLS concepts to ICD codes). We then apply the best-performing model to label an in-house EHR dataset containing patient histories from 2017 to 2021. Our experiments, conducted on a carefully curated test set, demonstrate that training with the automated predicted codes leads to a significant improvement in accuracy compared to manually annotated data from physicians. We believe our findings offer valuable insights into the potential for automating clinical coding in resource-limited languages like Russian, which could enhance clinical efficiency and data accuracy in these contexts.

ICD Coding aims to assign a wide range of medical codes to a medical text document, which is a popular and challenging task in the healthcare domain. To alleviate the problems of long-tail distribution and the lack of annotations of code-specific evidence, many previous works have proposed incorporating code knowledge to improve coding performance. However, existing methods often focus on a single type of knowledge and design specialized modules that are complex and incompatible with each other, thereby limiting their scalability and effectiveness. To address this issue, we propose GKI-ICD, a novel, general knowledge injection framework that integrates three key types of knowledge, namely ICD Description, ICD Synonym, and ICD Hierarchy, without specialized design of additional modules. The comprehensive utilization of the above knowledge, which exhibits both differences and complementarity, can effectively enhance the ICD coding performance. Extensive experiments on existing popular ICD coding benchmarks demonstrate the effectiveness of GKI-ICD, which achieves the state-of-the-art performance on most evaluation metrics. Code is available at https://github.com/xuzhang0112/GKI-ICD.

This study aims to explore the implementation of Natural Language Processing (NLP) and machine learning (ML) techniques to automate the coding of medical letters with visualised explainability and light-weighted local computer settings. Currently in clinical settings, coding is a manual process that involves assigning codes to each condition, procedure, and medication in a patient's paperwork (e.g., 56265001 heart disease using SNOMED CT code). There are preliminary research on automatic coding in this field using state-of-the-art ML models; however, due to the complexity and size of the models, the real-world deployment is not achieved. To further facilitate the possibility of automatic coding practice, we explore some solutions in a local computer setting; in addition, we explore the function of explainability for transparency of AI models. We used the publicly available MIMIC-III database and the HAN/HLAN network models for ICD code prediction purposes. We also experimented with the mapping between ICD and SNOMED CT knowledge bases. In our experiments, the models provided useful information for 97.98\% of codes. The result of this investigation can shed some light on implementing automatic clinical coding in practice, such as in hospital settings, on the local computers used by clinicians , project page https://github.com/Glenj01/Medical-Coding.

International Classification of Disease (ICD) coding procedure which refers to tagging medical notes with diagnosis codes has been shown to be effective and crucial to the billing system in medical sector. Currently, ICD codes are assigned to a clinical note manually which is likely to cause many errors. Moreover, training skilled coders also requires time and human resources. Therefore, automating the ICD code determination process is an important task. With the advancement of artificial intelligence theory and computational hardware, machine learning approach has emerged as a suitable solution to automate this process. In this project, we apply a transformer-based architecture to capture the interdependence among the tokens of a document and then use a code-wise attention mechanism to learn code-specific representations of the entire document. Finally, they are fed to separate dense layers for corresponding code prediction. Furthermore, to handle the imbalance in the code frequency of clinical datasets, we employ a label distribution aware margin (LDAM) loss function. The experimental results on the MIMIC-III dataset show that our proposed model outperforms other baselines by a significant margin. In particular, our best setting achieves a micro-AUC score of 0.923 compared to 0.868 of bidirectional recurrent neural networks. We also show that by using the code-wise attention mechanism, the model can provide more insights about its prediction, and thus it can support clinicians to make reliable decisions. Our code is available online (https://github.com/biplob1ly/TransICD)

Image copy detection (ICD) aims to determine whether a query image is an edited copy of any image from a reference set. Currently, there are very limited public benchmarks for ICD, while all overlook a critical challenge in real-world applications, i.e., the distraction from hard negative queries. Specifically, some queries are not edited copies but are inherently similar to some reference images. These hard negative queries are easily false recognized as edited copies, significantly compromising the ICD accuracy. This observation motivates us to build the first ICD benchmark featuring this characteristic. Based on existing ICD datasets, this paper constructs a new dataset by additionally adding 100, 000 and 24, 252 hard negative pairs into the training and test set, respectively. Moreover, this paper further reveals a unique difficulty for solving the hard negative problem in ICD, i.e., there is a fundamental conflict between current metric learning and ICD. This conflict is: the metric learning adopts symmetric distance while the edited copy is an asymmetric (unidirectional) process, e.g., a partial crop is close to its holistic reference image and is an edited copy, while the latter cannot be the edited copy of the former (in spite the distance is equally small). This insight results in an Asymmetrical-Similarity Learning (ASL) method, which allows the similarity in two directions (the query <-> the reference image) to be different from each other. Experimental results show that ASL outperforms state-of-the-art methods by a clear margin, confirming that solving the symmetric-asymmetric conflict is critical for ICD. The NDEC dataset and code are available at https://github.com/WangWenhao0716/ASL.

Learning to represent free text is a core task in many clinical machine learning (ML) applications, as clinical text contains observations and plans not otherwise available for inference. State-of-the-art methods use large language models developed with immense computational resources and training data; however, applying these models is challenging because of the highly varying syntax and vocabulary in clinical free text. Structured information such as International Classification of Disease (ICD) codes often succinctly abstracts the most important facts of a clinical encounter and yields good performance, but is often not as available as clinical text in real-world scenarios. We propose a multi-view learning framework that jointly learns from codes and text to combine the availability and forward-looking nature of text and better performance of ICD codes. The learned text embeddings can be used as inputs to predictive algorithms independent of the ICD codes during inference. Our approach uses a Graph Neural Network (GNN) to process ICD codes, and Bi-LSTM to process text. We apply Deep Canonical Correlation Analysis (DCCA) to enforce the two views to learn a similar representation of each patient. In experiments using planned surgical procedure text, our model outperforms BERT models fine-tuned to clinical data, and in experiments using diverse text in MIMIC-III, our model is competitive to a fine-tuned BERT at a tiny fraction of its computational effort.

In-Context Learning (ICL) is a technique by which language models make predictions based on examples provided in their input context. Previously, their context window size imposed a limit on the number of examples that can be shown, making example selection techniques crucial for identifying the maximally effective set of examples. However, the recent advent of Long Context Language Models (LCLMs) has significantly increased the number of examples that can be included in context, raising an important question of whether ICL performance in a many-shot regime is still sensitive to the method of sample selection. To answer this, we revisit these approaches in the context of LCLMs through extensive experiments on 18 datasets spanning 4 tasks. Surprisingly, we observe that sophisticated example selection techniques do not yield significant improvements over a simple random sample selection method. Instead, we find that the advent of LCLMs has fundamentally shifted the challenge of ICL from that of selecting the most effective examples to that of collecting sufficient examples to fill the context window. Specifically, in certain datasets, including all available examples does not fully utilize the context window; however, by augmenting the examples in context with a simple data augmentation approach, we substantially improve ICL performance by 5%.

In-context learning (ICL) improves language models' performance on a variety of NLP tasks by simply demonstrating a handful of examples at inference time. It is not well understood why ICL ability emerges, as the model has never been specifically trained on such demonstrations. Unlike prior work that explores implicit mechanisms behind ICL, we study ICL via investigating the pretraining data. Specifically, we first adapt an iterative, gradient-based approach to find a small subset of pretraining data that supports ICL. We observe that a continued pretraining on this small subset significantly improves the model's ICL ability, by up to 18%. We then compare the supportive subset constrastively with random subsets of pretraining data and discover: (1) The supportive pretraining data to ICL do not have a higher domain relevance to downstream tasks. (2) The supportive pretraining data have a higher mass of rarely occurring, long-tail tokens. (3) The supportive pretraining data are challenging examples where the information gain from long-range context is below average, indicating learning to incorporate difficult long-range context encourages ICL. Our work takes a first step towards understanding ICL via analyzing instance-level pretraining data. Our insights have a potential to enhance the ICL ability of language models by actively guiding the construction of pretraining data in the future.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

In-context learning (ICL) is the ability of a model to learn a new task by observing a few exemplars in its context. While prevalent in NLP, this capability has recently also been observed in Reinforcement Learning (RL) settings. Prior in-context RL methods, however, require entire episodes in the agent's context. Given that complex environments typically lead to long episodes with sparse rewards, these methods are constrained to simple environments with short episodes. To address these challenges, we introduce Retrieval-Augmented Decision Transformer (RA-DT). RA-DT employs an external memory mechanism to store past experiences from which it retrieves only sub-trajectories relevant for the current situation. The retrieval component in RA-DT does not require training and can be entirely domain-agnostic. We evaluate the capabilities of RA-DT on grid-world environments, robotics simulations, and procedurally-generated video games. On grid-worlds, RA-DT outperforms baselines, while using only a fraction of their context length. Furthermore, we illuminate the limitations of current in-context RL methods on complex environments and discuss future directions. To facilitate future research, we release datasets for four of the considered environments.

In-context learning (ICL) has transformed the use of large language models (LLMs) for NLP tasks, enabling few-shot learning by conditioning on labeled examples without finetuning. Despite its effectiveness, ICL is prone to errors, especially for challenging examples. With the goal of improving the performance of ICL, we propose corrective in-context learning (CICL), an approach that incorporates a model's incorrect predictions alongside ground truth corrections into the prompt, aiming to enhance classification accuracy through self-correction. However, contrary to our hypothesis, extensive experiments on text classification tasks demonstrate that CICL consistently underperforms standard ICL, with performance degrading as the proportion of corrections in the prompt increases. Our findings indicate that CICL introduces confusion by disrupting the model's task understanding, rather than refining its predictions. Additionally, we observe that presenting harder examples in standard ICL does not improve performance, suggesting that example difficulty alone may not be a reliable criterion for effective selection. By presenting these negative results, we provide important insights into the limitations of self-corrective mechanisms in LLMs and offer directions for future research.

Automated structured radiology report generation (SRRG) from chest X-ray images offers significant potential to reduce workload of radiologists by generating reports in structured formats that ensure clarity, consistency, and adherence to clinical reporting standards. While radiologists effectively utilize available clinical contexts in their diagnostic reasoning, existing SRRG systems overlook these essential elements. This fundamental gap leads to critical problems including temporal hallucinations when referencing non-existent clinical contexts. To address these limitations, we propose contextualized SRRG (C-SRRG) that comprehensively incorporates rich clinical context for SRRG. We curate C-SRRG dataset by integrating comprehensive clinical context encompassing 1) multi-view X-ray images, 2) clinical indication, 3) imaging techniques, and 4) prior studies with corresponding comparisons based on patient histories. Through extensive benchmarking with state-of-the-art multimodal large language models, we demonstrate that incorporating clinical context with the proposed C-SRRG significantly improves report generation quality. We publicly release dataset, code, and checkpoints to facilitate future research for clinically-aligned automated RRG at https://github.com/vuno/contextualized-srrg.

The first ACM/IEEE TinyML Design Contest (TDC) held at the 41st International Conference on Computer-Aided Design (ICCAD) in 2022 is a challenging, multi-month, research and development competition. TDC'22 focuses on real-world medical problems that require the innovation and implementation of artificial intelligence/machine learning (AI/ML) algorithms on implantable devices. The challenge problem of TDC'22 is to develop a novel AI/ML-based real-time detection algorithm for life-threatening ventricular arrhythmia over low-power microcontrollers utilized in Implantable Cardioverter-Defibrillators (ICDs). The dataset contains more than 38,000 5-second intracardiac electrograms (IEGMs) segments over 8 different types of rhythm from 90 subjects. The dedicated hardware platform is NUCLEO-L432KC manufactured by STMicroelectronics. TDC'22, which is open to multi-person teams world-wide, attracted more than 150 teams from over 50 organizations. This paper first presents the medical problem, dataset, and evaluation procedure in detail. It further demonstrates and discusses the designs developed by the leading teams as well as representative results. This paper concludes with the direction of improvement for the future TinyML design for health monitoring applications.

In-context learning (ICL) involves reasoning from given contextual examples. As more modalities comes, this procedure is becoming more challenging as the interleaved input modalities convolutes the understanding process. This is exemplified by the observation that multimodal models often struggle to effectively extrapolate from contextual examples to perform ICL. To address these challenges, we introduce MultiModal In-conteXt Tuning (M^2IXT), a lightweight module to enhance the ICL capabilities of multimodal unified models. The proposed M^2IXT module perceives an expandable context window to incorporate various labeled examples of multiple modalities (e.g., text, image, and coordinates). It can be prepended to various multimodal unified models (e.g., OFA, Unival, LLaVA) of different architectures and trained via a mixed-tasks strategy to enable rapid few-shot adaption on multiple tasks and datasets. When tuned on as little as 50K multimodal data, M^2IXT can boost the few-shot ICL performance significantly (e.g., 18\% relative increase for OFA), and obtained state-of-the-art results across an array of tasks including visual question answering, image captioning, visual grounding, and visual entailment, while being considerably small in terms of model parameters (e.g., sim20times smaller than Flamingo or MMICL), highlighting the flexibility and effectiveness of M^2IXT as a multimodal in-context learner.

Automatically classifying electronic health records (EHRs) into diagnostic codes has been challenging to the NLP community. State-of-the-art methods treated this problem as a multilabel classification problem and proposed various architectures to model this problem. However, these systems did not leverage the superb performance of pretrained language models, which achieved superb performance on natural language understanding tasks. Prior work has shown that pretrained language models underperformed on this task with the regular finetuning scheme. Therefore, this paper aims at analyzing the causes of the underperformance and developing a framework for automatic ICD coding with pretrained language models. We spotted three main issues through the experiments: 1) large label space, 2) long input sequences, and 3) domain mismatch between pretraining and fine-tuning. We propose PLMICD, a framework that tackles the challenges with various strategies. The experimental results show that our proposed framework can overcome the challenges and achieves state-of-the-art performance in terms of multiple metrics on the benchmark MIMIC data. The source code is available at https://github.com/MiuLab/PLM-ICD

In-context learning (ICL) is a powerful paradigm emerged from large language models (LLMs). Despite its promises, ICL performance is known to be highly sensitive to input examples. In this work, we use in-context influences to analyze few-shot ICL performance directly from the in-context examples. Our proposed influence-based example selection method can identify both positive and negative examples, outperforming several baselines when evaluated on 9 SuperGLUE tasks. Our analysis uncovers up to a 16.3% performance gap between using the most negative in-context examples compared to the most positive. In a case study, we apply our influence-based framework to quantify the phenomena of recency bias in example ordering for few-shot ICL.

In-context learning (ICL) enables Large Language Models (LLMs) to perform tasks using few demonstrations, facilitating task adaptation when labeled examples are hard to obtain. However, ICL is sensitive to the choice of demonstrations, and it remains unclear which demonstration attributes enable in-context generalization. In this work, we conduct a perturbation study of in-context demonstrations for low-resource Named Entity Detection (NED). Our surprising finding is that in-context demonstrations with partially correct annotated entity mentions can be as effective for task transfer as fully correct demonstrations. Based off our findings, we propose Pseudo-annotated In-Context Learning (PICLe), a framework for in-context learning with noisy, pseudo-annotated demonstrations. PICLe leverages LLMs to annotate many demonstrations in a zero-shot first pass. We then cluster these synthetic demonstrations, sample specific sets of in-context demonstrations from each cluster, and predict entity mentions using each set independently. Finally, we use self-verification to select the final set of entity mentions. We evaluate PICLe on five biomedical NED datasets and show that, with zero human annotation, PICLe outperforms ICL in low-resource settings where limited gold examples can be used as in-context demonstrations.

In-context learning (ICL) allows a language model to improve its problem-solving capability when provided with suitable information in context. Since the choice of in-context information can be determined based on the problem itself, in-context learning is analogous to human learning from teachers in a classroom. Recent works (Didolkar et al., 2024a; 2024b) show that ICL performance can be improved by leveraging a frontier large language model's (LLM) ability to predict required skills to solve a problem, popularly referred to as an LLM's metacognition, and using the recommended skills to construct necessary in-context examples. While this skill-based strategy boosts ICL performance in larger models, its gains on small language models (SLMs) have been minimal, highlighting a performance gap in ICL capabilities. We investigate this gap and show that skill-based prompting can hurt SLM performance on easy questions by introducing unnecessary information, akin to cognitive overload. To address this, we introduce AdaptMI, an adaptive approach to selecting skill-based in-context Math Instructions for SLMs. Inspired by cognitive load theory from human pedagogy, our method only introduces skill-based examples when the model performs poorly. We further propose AdaptMI+, which adds examples targeted to the specific skills missing from the model's responses. On 5-shot evaluations across popular math benchmarks and five SLMs (1B--7B; Qwen, Llama), AdaptMI+ improves accuracy by up to 6% over naive skill-based strategies.

In-context learning (ICL) i.e. showing LLMs only a few task-specific demonstrations has led to downstream gains with no task-specific fine-tuning required. However, LLMs are sensitive to the choice of prompts, and therefore a crucial research question is how to select good demonstrations for ICL. One effective strategy is leveraging semantic similarity between the ICL demonstrations and test inputs by using a text retriever, which however is sub-optimal as that does not consider the LLM's existing knowledge about that task. From prior work (Min et al., 2022), we already know that labels paired with the demonstrations bias the model predictions. This leads us to our hypothesis whether considering LLM's existing knowledge about the task, especially with respect to the output label space can help in a better demonstration selection strategy. Through extensive experimentation on three text classification tasks, we find that it is beneficial to not only choose semantically similar ICL demonstrations but also to choose those demonstrations that help resolve the inherent label ambiguity surrounding the test example. Interestingly, we find that including demonstrations that the LLM previously mis-classified and also fall on the test example's decision boundary, brings the most performance gain.

Foundation Models (FMs) trained on Electronic Health Records (EHRs) have achieved state-of-the-art results on numerous clinical prediction tasks. However, most existing EHR FMs have context windows of <1k tokens. This prevents them from modeling full patient EHRs which can exceed 10k's of events. Recent advancements in subquadratic long-context architectures (e.g., Mamba) offer a promising solution. However, their application to EHR data has not been well-studied. We address this gap by presenting the first systematic evaluation of the effect of context length on modeling EHR data. We find that longer context models improve predictive performance -- our Mamba-based model surpasses the prior state-of-the-art on 9/14 tasks on the EHRSHOT prediction benchmark. For clinical applications, however, model performance alone is insufficient -- robustness to the unique properties of EHR is crucial. Thus, we also evaluate models across three previously underexplored properties of EHR data: (1) the prevalence of "copy-forwarded" diagnoses which creates artificial repetition of tokens within EHR sequences; (2) the irregular time intervals between EHR events which can lead to a wide range of timespans within a context window; and (3) the natural increase in disease complexity over time which makes later tokens in the EHR harder to predict than earlier ones. Stratifying our EHRSHOT results, we find that higher levels of each property correlate negatively with model performance, but that longer context models are more robust to more extreme levels of these properties. Our work highlights the potential for using long-context architectures to model EHR data, and offers a case study for identifying new challenges in modeling sequential data motivated by domains outside of natural language. We release our models and code at: https://github.com/som-shahlab/long_context_clues

Multimodal in-context learning (ICL) remains underexplored despite significant potential for domains such as medicine. Clinicians routinely encounter diverse, specialized tasks requiring adaptation from limited examples, such as drawing insights from a few relevant prior cases or considering a constrained set of differential diagnoses. While multimodal large language models (MLLMs) have shown advances in medical visual question answering (VQA), their ability to learn multimodal tasks from context is largely unknown. We introduce SMMILE, the first expert-driven multimodal ICL benchmark for medical tasks. Eleven medical experts curated problems, each including a multimodal query and multimodal in-context examples as task demonstrations. SMMILE encompasses 111 problems (517 question-image-answer triplets) covering 6 medical specialties and 13 imaging modalities. We further introduce SMMILE++, an augmented variant with 1038 permuted problems. A comprehensive evaluation of 15 MLLMs demonstrates that most models exhibit moderate to poor multimodal ICL ability in medical tasks. In open-ended evaluations, ICL contributes only 8% average improvement over zero-shot on SMMILE and 9.4% on SMMILE++. We observe a susceptibility for irrelevant in-context examples: even a single noisy or irrelevant example can degrade performance by up to 9.5%. Moreover, example ordering exhibits a recency bias, i.e., placing the most relevant example last can lead to substantial performance improvements by up to 71%. Our findings highlight critical limitations and biases in current MLLMs when learning multimodal medical tasks from context.

Automatic International Classification of Diseases (ICD) coding aims to assign multiple ICD codes to a medical note with average length of 3,000+ tokens. This task is challenging due to a high-dimensional space of multi-label assignment (tens of thousands of ICD codes) and the long-tail challenge: only a few codes (common diseases) are frequently assigned while most codes (rare diseases) are infrequently assigned. This study addresses the long-tail challenge by adapting a prompt-based fine-tuning technique with label semantics, which has been shown to be effective under few-shot setting. To further enhance the performance in medical domain, we propose a knowledge-enhanced longformer by injecting three domain-specific knowledge: hierarchy, synonym, and abbreviation with additional pretraining using contrastive learning. Experiments on MIMIC-III-full, a benchmark dataset of code assignment, show that our proposed method outperforms previous state-of-the-art method in 14.5% in marco F1 (from 10.3 to 11.8, P<0.001). To further test our model on few-shot setting, we created a new rare diseases coding dataset, MIMIC-III-rare50, on which our model improves marco F1 from 17.1 to 30.4 and micro F1 from 17.2 to 32.6 compared to previous method.

The predictions of Large Language Models (LLMs) on downstream tasks often improve significantly when including examples of the input--label relationship in the context. However, there is currently no consensus about how this in-context learning (ICL) ability of LLMs works. For example, while Xie et al. (2021) liken ICL to a general-purpose learning algorithm, Min et al. (2022) argue ICL does not even learn label relationships from in-context examples. In this paper, we provide novel insights into how ICL leverages label information, revealing both capabilities and limitations. To ensure we obtain a comprehensive picture of ICL behavior, we study probabilistic aspects of ICL predictions and thoroughly examine the dynamics of ICL as more examples are provided. Our experiments show that ICL predictions almost always depend on in-context labels and that ICL can learn truly novel tasks in-context. However, we also find that ICL struggles to fully overcome prediction preferences acquired from pre-training data and, further, that ICL does not consider all in-context information equally.

In-context Learning (ICL) is the ability of Large Language Models (LLMs) to perform new tasks when conditioned on prompts comprising a few task examples. However, ICL performance can be critically sensitive to the choice of examples. To dynamically select the best examples for every test input, we propose Example Gisting, a novel approach for training example encoders through supervised fine-tuning with an attention bottleneck between the inputs and outputs. These gist models form the basis for GistScore, a novel metric for scoring and selecting informative examples. Further, we experiment with two variations: (1) fine-tuning gist models for each dataset and (2) multi-task training a single model on a large collection of datasets. The latter can be used for new tasks out-of-the-box, enabling a training-free ICL pipeline. Evaluations with 21 datasets spanning 9 tasks and 8 diverse LLMs show that our fine-tuned models get state-of-the-art ICL performance with over 20% absolute gain over off-the-shelf retrievers and 5% over the best prior methods. Further, our multi-task model generalizes well to new tasks, datasets, and prompt templates. Selection using this model matches or outperforms prior methods while being three orders of magnitude faster than the strongest training-free baseline.

While most existing works on LLM prompting techniques focus only on how to select a better set of data samples inside one single prompt input (In-Context Learning or ICL), why can not we design and leverage multiple prompts together to further improve the LLM's performance? In this work, we propose In-Context Sampling (ICS), a low-resource LLM prompting technique to produce confident predictions by optimizing the construction of multiple ICL prompt inputs. Extensive experiments with three open-source LLMs (FlanT5-XL, Mistral-7B, and Mixtral-8x7B) on four NLI datasets (e-SNLI, Multi-NLI, ANLI, and Contract-NLI) and one QA dataset (CommonsenseQA) illustrate that ICS can consistently enhance LLMs' performance. An in-depth evaluation with three data similarity-based ICS strategies suggests that these strategies can further elevate LLM's performance, which sheds light on a new yet promising future research direction.

Building image classification models remains cumbersome in data-scarce domains, where collecting large labeled datasets is impractical. In-context learning (ICL) has emerged as a promising paradigm for few-shot image classification (FSIC), enabling models to generalize across domains without gradient-based adaptation. However, prior work has largely overlooked a critical component of ICL-based FSIC pipelines: the role of image embeddings. In this work, we present PictSure, an ICL framework that places the embedding model -- its architecture, pretraining, and training dynamics -- at the center of analysis. We systematically examine the effects of different visual encoder types, pretraining objectives, and fine-tuning strategies on downstream FSIC performance. Our experiments show that the training success and the out-of-domain performance are highly dependent on how the embedding models are pretrained. Consequently, PictSure manages to outperform existing ICL-based FSIC models on out-of-domain benchmarks that differ significantly from the training distribution, while maintaining comparable results on in-domain tasks. Code can be found at https://github.com/PictSure/pictsure-library.

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios.

In-context learning (ICL) emerges as a promising capability of large language models (LLMs) by providing them with demonstration examples to perform diverse tasks. However, the underlying mechanism of how LLMs learn from the provided context remains under-explored. In this paper, we investigate the working mechanism of ICL through an information flow lens. Our findings reveal that label words in the demonstration examples function as anchors: (1) semantic information aggregates into label word representations during the shallow computation layers' processing; (2) the consolidated information in label words serves as a reference for LLMs' final predictions. Based on these insights, we introduce an anchor re-weighting method to improve ICL performance, a demonstration compression technique to expedite inference, and an analysis framework for diagnosing ICL errors in GPT2-XL. The promising applications of our findings again validate the uncovered ICL working mechanism and pave the way for future studies.

Large language models (LLMs) famously exhibit emergent in-context learning (ICL) -- the ability to rapidly adapt to new tasks using few-shot examples provided as a prompt, without updating the model's weights. Built on top of LLMs, vision large language models (VLLMs) have advanced significantly in areas such as recognition, reasoning, and grounding. However, investigations into multimodal ICL have predominantly focused on few-shot visual question answering (VQA), and image captioning, which we will show neither exploit the strengths of ICL, nor test its limitations. The broader capabilities and limitations of multimodal ICL remain under-explored. In this study, we introduce a comprehensive benchmark VL-ICL Bench for multimodal in-context learning, encompassing a broad spectrum of tasks that involve both images and text as inputs and outputs, and different types of challenges, from {perception to reasoning and long context length}. We evaluate the abilities of state-of-the-art VLLMs against this benchmark suite, revealing their diverse strengths and weaknesses, and showing that even the most advanced models, such as GPT-4, find the tasks challenging. By highlighting a range of new ICL tasks, and the associated strengths and limitations of existing models, we hope that our dataset will inspire future work on enhancing the in-context learning capabilities of VLLMs, as well as inspire new applications that leverage VLLM ICL. The code and dataset are available at https://github.com/ys-zong/VL-ICL.

In-context Learning (ICL) empowers large language models (LLMs) to adapt to unseen tasks during inference by prefixing a few demonstration examples prior to test queries. Despite its versatility, ICL incurs substantial computational and memory overheads compared to zero-shot learning and is susceptible to the selection and order of demonstration examples. In this work, we introduce Implicit In-context Learning (I2CL), an innovative paradigm that addresses the challenges associated with traditional ICL by absorbing demonstration examples within the activation space. I2CL first generates a condensed vector representation, namely a context vector, from the demonstration examples. It then integrates the context vector during inference by injecting a linear combination of the context vector and query activations into the model's residual streams. Empirical evaluation on nine real-world tasks across three model architectures demonstrates that I2CL achieves few-shot performance with zero-shot cost and exhibits robustness against the variation of demonstration examples. Furthermore, I2CL facilitates a novel representation of "task-ids", enhancing task similarity detection and enabling effective transfer learning. We provide a comprehensive analysis of I2CL, offering deeper insights into its mechanisms and broader implications for ICL. The source code is available at: https://github.com/LzVv123456/I2CL.

In-context Learning (ICL) enables large language models (LLMs) to tackle downstream tasks through sophisticated prompting and high-quality demonstrations. However, this traditional ICL paradigm shows limitations when facing complex mathematical reasoning tasks, primarily due to its heavy dependence on example quality and the necessity for human intervention in challenging scenarios. To address these limitations, this paper presents HiAR-ICL, a High-level Automated Reasoning paradigm in ICL that shifts focus from specific examples to abstract thinking patterns, extending the conventional concept of context in ICL. HiAR-ICL introduces five atomic reasoning actions as fundamental components for constructing chain-structured patterns. Using Monte Carlo Tree Search, we explore reasoning paths and construct thought cards to guide subsequent inference. We then develop a cognitive complexity framework that dynamically matches problems with appropriate thought cards. Experimental results demonstrate HiAR-ICL's effectiveness, achieving state-of-the-art accuracy (79.6%) on the MATH benchmark with Qwen2.5-7B-Instruct, surpassing GPT-4o (76.6%) and Claude 3.5 (71.1%).

Given the clinical notes written in electronic health records (EHRs), it is challenging to predict the diagnostic codes which is formulated as a multi-label classification task. The large set of labels, the hierarchical dependency, and the imbalanced data make this prediction task extremely hard. Most existing work built a binary prediction for each label independently, ignoring the dependencies between labels. To address this problem, we propose a two-stage framework to improve automatic ICD coding by capturing the label correlation. Specifically, we train a label set distribution estimator to rescore the probability of each label set candidate generated by a base predictor. This paper is the first attempt at learning the label set distribution as a reranking module for medical code prediction. In the experiments, our proposed framework is able to improve upon best-performing predictors on the benchmark MIMIC datasets. The source code of this project is available at https://github.com/MiuLab/ICD-Correlation.

In-context learning (ICL) is a critical emerging capability of large language models (LLMs), enabling few-shot learning during inference by including a few demonstrations (demos) in the prompt. However, it has been found that ICL's performance can be sensitive to the choices of demos and their order. This paper investigates an unexplored new positional bias of ICL for the first time: we observe that the predictions and accuracy can drift drastically when the positions of demos, the system prompt, and the user message in LLM input are varied. We refer to this bias as DEMOS' POSITION IN PROMPT (DPP) bias. We design a systematic evaluation pipeline to study this type of positional bias across classification, question answering, summarization, and reasoning tasks. We introduce two metrics, ACCURACY-CHANGE and PREDICTION-CHANGE, to quantify net gains and output volatility induced by changes in the demos' position. Extensive experiments on ten LLMs from four open-source model families (QWEN, LLAMA3, MISTRAL, COHERE) verify that the bias significantly affects their accuracy and predictions: placing demos at the start of the prompt yields the most stable and accurate outputs with gains of up to +6 points. In contrast, placing demos at the end of the user message flips over 30\% of predictions without improving correctness on QA tasks. Smaller models are most affected by this sensitivity, though even large models remain marginally affected on complex tasks.

Recent advancements in large language models (LLM) capable of processing extremely long texts highlight the need for a dedicated evaluation benchmark to assess their long-context capabilities. However, existing methods, like the needle-in-a-haystack test, do not effectively assess whether these models fully utilize contextual information, raising concerns about the reliability of current evaluation techniques. To thoroughly examine the effectiveness of existing benchmarks, we introduce a new metric called information coverage (IC), which quantifies the proportion of the input context necessary for answering queries. Our findings indicate that current benchmarks exhibit low IC; although the input context may be extensive, the actual usable context is often limited. To address this, we present ETHIC, a novel benchmark designed to assess LLMs' ability to leverage the entire context. Our benchmark comprises 2,648 test instances spanning four long-context tasks with high IC scores in the domains of books, debates, medicine, and law. Our evaluations reveal significant performance drops in contemporary LLMs, highlighting a critical challenge in managing long contexts. Our benchmark is available at https://github.com/dmis-lab/ETHIC.

Physicians spend significant time documenting clinical encounters, a burden that contributes to professional burnout. To address this, robust automation tools for medical documentation are crucial. We introduce MedSynth -- a novel dataset of synthetic medical dialogues and notes designed to advance the Dialogue-to-Note (Dial-2-Note) and Note-to-Dialogue (Note-2-Dial) tasks. Informed by an extensive analysis of disease distributions, this dataset includes over 10,000 dialogue-note pairs covering over 2000 ICD-10 codes. We demonstrate that our dataset markedly enhances the performance of models in generating medical notes from dialogues, and dialogues from medical notes. The dataset provides a valuable resource in a field where open-access, privacy-compliant, and diverse training data are scarce. Code is available at https://github.com/ahmadrezarm/MedSynth/tree/main and the dataset is available at https://huggingface.co/datasets/Ahmad0067/MedSynth.

This study investigates the feasibility and performance of federated learning (FL) for multi-label ICD code classification using clinical notes from the MIMIC-IV dataset. Unlike previous approaches that rely on centralized training or fine-tuned large language models, we propose a lightweight and scalable pipeline combining frozen text embeddings with simple multilayer perceptron (MLP) classifiers. This design offers a privacy-preserving and deployment-efficient alternative for clinical NLP applications, particularly suited to distributed healthcare settings. Extensive experiments across both centralized and federated configurations were conducted, testing six publicly available embedding models from Massive Text Embedding Benchmark leaderboard and three MLP classifier architectures under two medical coding (ICD-9 and ICD-10). Additionally, ablation studies over ten random stratified splits assess performance stability. Results show that embedding quality substantially outweighs classifier complexity in determining predictive performance, and that federated learning can closely match centralized results in idealized conditions. While the models are orders of magnitude smaller than state-of-the-art architectures and achieved competitive micro and macro F1 scores, limitations remain including the lack of end-to-end training and the simplified FL assumptions. Nevertheless, this work demonstrates a viable way toward scalable, privacy-conscious medical coding systems and offers a step toward for future research into federated, domain-adaptive clinical AI.

The rapid advancement of large language models (LLMs) has accelerated the emergence of in-context learning (ICL) as a cutting-edge approach in the natural language processing domain. Recently, ICL has been employed in visual understanding tasks, such as semantic segmentation and image captioning, yielding promising results. However, existing visual ICL framework can not enable producing content across multiple modalities, which limits their potential usage scenarios. To address this issue, we present a new ICL framework for visual understanding with multi-modal output enabled. First, we quantize and embed both text and visual prompt into a unified representational space, structured as interleaved in-context sequences. Then a decoder-only sparse transformer architecture is employed to perform generative modeling on them, facilitating in-context learning. Thanks to this design, the model is capable of handling in-context vision understanding tasks with multimodal output in a unified pipeline. Experimental results demonstrate that our model achieves competitive performance compared with specialized models and previous ICL baselines. Overall, our research takes a further step toward unified multimodal in-context learning.

In-context learning (ICL) is a new learning paradigm that has gained popularity along with the development of large language models. In this work, we adapt a recently proposed hardness metric, pointwise V-usable information (PVI), to an in-context version (in-context PVI). Compared to the original PVI, in-context PVI is more efficient in that it requires only a few exemplars and does not require fine-tuning. We conducted a comprehensive empirical analysis to evaluate the reliability of in-context PVI. Our findings indicate that in-context PVI estimates exhibit similar characteristics to the original PVI. Specific to the in-context setting, we show that in-context PVI estimates remain consistent across different exemplar selections and numbers of shots. The variance of in-context PVI estimates across different exemplar selections is insignificant, which suggests that in-context PVI are stable. Furthermore, we demonstrate how in-context PVI can be employed to identify challenging instances. Our work highlights the potential of in-context PVI and provides new insights into the capabilities of ICL.

In-context Learning (ICL) is one of the key methods for enhancing the performance of large language models on specific tasks by providing a set of few-shot examples. However, the ICL capability of different types of models shows significant variation due to factors such as model architecture, volume of learning data, and the size of parameters. Generally, the larger the model's parameter size and the more extensive the learning data, the stronger its ICL capability. In this paper, we propose a method SLEICL that involves learning from examples using strong language models and then summarizing and transferring these learned skills to weak language models for inference and application. This ensures the stability and effectiveness of ICL. Compared to directly enabling weak language models to learn from prompt examples, SLEICL reduces the difficulty of ICL for these models. Our experiments, conducted on up to eight datasets with five language models, demonstrate that weak language models achieve consistent improvement over their own zero-shot or few-shot capabilities using the SLEICL method. Some weak language models even surpass the performance of GPT4-1106-preview (zero-shot) with the aid of SLEICL.

The remarkable capability of large language models (LLMs) for in-context learning (ICL) needs to be activated by demonstration examples. Prior work has extensively explored the selection of examples for ICL, predominantly following the "select then organize" paradigm, such approaches often neglect the internal relationships between examples and exist an inconsistency between the training and inference. In this paper, we formulate the problem as a sequential selection problem and introduce Se^2, a sequential-aware method that leverages the LLM's feedback on varying context, aiding in capturing inter-relationships and sequential information among examples, significantly enriching the contextuality and relevance of ICL prompts. Meanwhile, we utilize beam search to seek and construct example sequences, enhancing both quality and diversity. Extensive experiments across 23 NLP tasks from 8 distinct categories illustrate that Se^2 markedly surpasses competitive baselines and achieves 42% relative improvement over random selection. Further in-depth analysis show the effectiveness of proposed strategies, highlighting Se^2's exceptional stability and adaptability across various scenarios. Our code will be released to facilitate future research.

Rare diseases present unique challenges in healthcare, often suffering from delayed diagnosis and fragmented information landscapes. The scarcity of reliable knowledge in these conditions poses a distinct challenge for Large Language Models (LLMs) in supporting clinical management and delivering precise patient information underscoring the need for focused training on these 'zebra' cases. We present Zebra-Llama, a specialized context-aware language model with high precision Retrieval Augmented Generation (RAG) capability, focusing on Ehlers-Danlos Syndrome (EDS) as our case study. EDS, affecting 1 in 5,000 individuals, exemplifies the complexities of rare diseases with its diverse symptoms, multiple subtypes, and evolving diagnostic criteria. By implementing a novel context-aware fine-tuning methodology trained on questions derived from medical literature, patient experiences, and clinical resources, along with expertly curated responses, Zebra-Llama demonstrates unprecedented capabilities in handling EDS-related queries. On a test set of real-world questions collected from EDS patients and clinicians, medical experts evaluated the responses generated by both models, revealing Zebra-Llama's substantial improvements over base model (Llama 3.1-8B-Instruct) in thoroughness (77.5% vs. 70.1%), accuracy (83.0% vs. 78.8%), clarity (74.7% vs. 72.0%) and citation reliability (70.6% vs. 52.3%). Released as an open-source resource, Zebra-Llama not only provides more accessible and reliable EDS information but also establishes a framework for developing specialized AI solutions for other rare conditions. This work represents a crucial step towards democratizing expert-level knowledge in rare disease management, potentially transforming how healthcare providers and patients navigate the complex landscape of rare diseases.

In-context learning (ICL) has emerged as a new approach to various natural language processing tasks, utilizing large language models (LLMs) to make predictions based on context that has been supplemented with a few examples or task-specific instructions. In this paper, we aim to extend this method to question answering tasks that utilize structured knowledge sources, and improve Text-to-SQL systems by exploring various prompt design strategies for employing LLMs. We conduct a systematic investigation into different demonstration selection methods and optimal instruction formats for prompting LLMs in the Text-to-SQL task. Our approach involves leveraging the syntactic structure of an example's SQL query to retrieve demonstrations, and we demonstrate that pursuing both diversity and similarity in demonstration selection leads to enhanced performance. Furthermore, we show that LLMs benefit from database-related knowledge augmentations. Our most effective strategy outperforms the state-of-the-art system by 2.5 points (Execution Accuracy) and the best fine-tuned system by 5.1 points on the Spider dataset. These results highlight the effectiveness of our approach in adapting LLMs to the Text-to-SQL task, and we present an analysis of the factors contributing to the success of our strategy.

Large language models (LLMs) have had a huge impact on society due to their impressive capabilities and vast knowledge of the world. Various applications and tools have been created that allow users to interact with these models in a black-box scenario. However, one limitation of this scenario is that users cannot modify the internal knowledge of the model, and the only way to add or modify internal knowledge is by explicitly mentioning it to the model during the current interaction. This learning process is called in-context training, and it refers to training that is confined to the user's current session or context. In-context learning has significant applications, but also has limitations that are seldom studied. In this paper, we present a study that shows how the model can suffer from interference between information that continually flows in the context, causing it to forget previously learned knowledge, which can reduce the model's performance. Along with showing the problem, we propose an evaluation benchmark based on the bAbI dataset.

In-context learning (ICL) allows LLMs to learn from examples without changing their weights, which is a particularly promising capability for long-context LLMs that can potentially learn from many examples. Recently, Lin et al. (2024) proposed URIAL, a method using only three in-context examples to align base LLMs, achieving non-trivial instruction following performance. In this work, we show that, while effective, ICL alignment with URIAL still underperforms compared to instruction fine-tuning on established benchmarks such as MT-Bench and AlpacaEval 2.0 (LC), especially with more capable base LMs. Unlike for tasks such as classification, translation, or summarization, adding more ICL demonstrations for long-context LLMs does not systematically improve instruction following performance. To address this limitation, we derive a greedy selection approach for ICL examples that noticeably improves performance, yet without bridging the gap to instruction fine-tuning. Finally, we provide a series of ablation studies to better understand the reasons behind the remaining gap, and we show how some aspects of ICL depart from the existing knowledge and are specific to the instruction tuning setting. Overall, our work advances the understanding of ICL as an alignment technique. We provide our code at https://github.com/tml-epfl/icl-alignment.

In-context learning (ICL) is an appealing approach for semantic parsing due to its few-shot nature and improved generalization. However, learning to parse to rare domain-specific languages (DSLs) from just a few demonstrations is challenging, limiting the performance of even the most capable LLMs. In this work, we improve the effectiveness of ICL for semantic parsing by (1) using general-purpose programming languages such as Python instead of DSLs, and (2) augmenting prompts with a structured domain description that includes, e.g., the available classes and functions. We show that both these changes significantly improve accuracy across three popular datasets. Combined, they lead to dramatic improvements (e.g. 7.9% to 66.5% on SMCalFlow compositional split), nearly closing the performance gap between easier i.i.d.\ and harder compositional splits when used with a strong model, and reducing the need for a large number of demonstrations. We find that the resemblance of the target parse language to general-purpose code is a more important factor than the language's popularity in pre-training corpora. Our findings provide an improved methodology for building semantic parsers in the modern context of ICL with LLMs.

In-context learning (ICL) using large language models for tasks with many labels is challenging due to the limited context window, which makes it difficult to fit a sufficient number of examples in the prompt. In this paper, we use a pre-trained dense retrieval model to bypass this limitation, giving the model only a partial view of the full label space for each inference call. Testing with recent open-source LLMs (OPT, LLaMA), we set new state of the art performance in few-shot settings for three common intent classification datasets, with no finetuning. We also surpass fine-tuned performance on fine-grained sentiment classification in certain cases. We analyze the performance across number of in-context examples and different model scales, showing that larger models are necessary to effectively and consistently make use of larger context lengths for ICL. By running several ablations, we analyze the model's use of: a) the similarity of the in-context examples to the current input, b) the semantic content of the class names, and c) the correct correspondence between examples and labels. We demonstrate that all three are needed to varying degrees depending on the domain, contrary to certain recent works.

Medical coding is essential for standardizing clinical data and communication but is often time-consuming and prone to errors. Traditional Natural Language Processing (NLP) methods struggle with automating coding due to the large label space, lengthy text inputs, and the absence of supporting evidence annotations that justify code selection. Recent advancements in Generative Artificial Intelligence (AI) offer promising solutions to these challenges. In this work, we introduce MedCodER, a Generative AI framework for automatic medical coding that leverages extraction, retrieval, and re-ranking techniques as core components. MedCodER achieves a micro-F1 score of 0.60 on International Classification of Diseases (ICD) code prediction, significantly outperforming state-of-the-art methods. Additionally, we present a new dataset containing medical records annotated with disease diagnoses, ICD codes, and supporting evidence texts (https://doi.org/10.5281/zenodo.13308316). Ablation tests confirm that MedCodER's performance depends on the integration of each of its aforementioned components, as performance declines when these components are evaluated in isolation.

Continuity of care is crucial to ensuring positive health outcomes for patients discharged from an inpatient hospital setting, and improved information sharing can help. To share information, caregivers write discharge notes containing action items to share with patients and their future caregivers, but these action items are easily lost due to the lengthiness of the documents. In this work, we describe our creation of a dataset of clinical action items annotated over MIMIC-III, the largest publicly available dataset of real clinical notes. This dataset, which we call CLIP, is annotated by physicians and covers 718 documents representing 100K sentences. We describe the task of extracting the action items from these documents as multi-aspect extractive summarization, with each aspect representing a type of action to be taken. We evaluate several machine learning models on this task, and show that the best models exploit in-domain language model pre-training on 59K unannotated documents, and incorporate context from neighboring sentences. We also propose an approach to pre-training data selection that allows us to explore the trade-off between size and domain-specificity of pre-training datasets for this task.

In-context learning (ICL), the ability of large language models to perform novel tasks by conditioning on a prompt with a few task examples, requires these examples to be informative about the test instance. The standard approach of independently ranking and selecting the most similar examples selects redundant examples while omitting important information. In this work, we show that BERTScore-Recall (BSR) selects better examples that demonstrate more of the salient aspects, e.g. reasoning patterns, of the test input. We further extend BSR and many standard metrics to easily optimizable set-level metrics, giving still better coverage of those salient aspects. On 15 datasets spanning 6 tasks and with 7 diverse LLMs, we show that (1) BSR is the superior metric for in-context example selection across the board, and (2) for compositional tasks, set selection using Set-BSR outperforms independent ranking by up to 17 points on average and, despite being training-free, surpasses methods that leverage task or LLM-specific training.

With the help of in-context learning (ICL), large language models (LLMs) have achieved impressive performance across various tasks. However, the function of descriptive instructions during ICL remains under-explored. In this work, we propose an ensemble prompt framework to describe the selection criteria of multiple in-context examples, and preliminary experiments on machine translation (MT) across six translation directions confirm that this framework boosts ICL perfromance. But to our surprise, LLMs might not necessarily care what the descriptions actually say, and the performance gain is primarily caused by the ensemble format, since the framework could lead to improvement even with random descriptive nouns. We further apply this new ensemble prompt on a range of commonsense, math, logical reasoning and hallucination tasks with three LLMs and achieve promising results, suggesting again that designing a proper prompt format would be much more effective and efficient than paying effort into specific descriptions. Our code will be publicly available once this paper is published.

In-Context Learning (ICL) enables Large Language Models (LLMs) to perform new tasks by conditioning on prompts with relevant information. Retrieval-Augmented Generation (RAG) enhances ICL by incorporating retrieved documents into the LLM's context at query time. However, traditional retrieval methods focus on semantic relevance, treating retrieval as a search problem. In this paper, we propose reframing retrieval for ICL as a recommendation problem, aiming to select documents that maximize utility in ICL tasks. We introduce the In-Context Learning Embedding and Reranker Benchmark (ICLERB), a novel evaluation framework that compares retrievers based on their ability to enhance LLM accuracy in ICL settings. Additionally, we propose a novel Reinforcement Learning-to-Rank from AI Feedback (RLRAIF) algorithm, designed to fine-tune retrieval models using minimal feedback from the LLM. Our experimental results reveal notable differences between ICLERB and existing benchmarks, and demonstrate that small models fine-tuned with our RLRAIF algorithm outperform large state-of-the-art retrieval models. These findings highlight the limitations of existing evaluation methods and the need for specialized benchmarks and training strategies adapted to ICL.

In-context learning (ICL) has shown impressive results in few-shot learning tasks, yet its underlying mechanism is still not fully understood. A recent line of work suggests that ICL performs gradient descent (GD)-based optimization implicitly. While appealing, much of the research focuses on simplified settings, where the parameters of a shallow model are optimized. In this work, we revisit evidence for ICL-GD correspondence on realistic NLP tasks and models. We find gaps in evaluation, both in terms of problematic metrics and insufficient baselines. We show that surprisingly, even untrained models achieve comparable ICL-GD similarity scores despite not exhibiting ICL. Next, we explore a major discrepancy in the flow of information throughout the model between ICL and GD, which we term Layer Causality. We propose a simple GD-based optimization procedure that respects layer causality, and show it improves similarity scores significantly.

In-context Learning (ICL) is an emerging few-shot learning paradigm on Language Models (LMs) with inner mechanisms un-explored. There are already existing works describing the inner processing of ICL, while they struggle to capture all the inference phenomena in large language models. Therefore, this paper proposes a comprehensive circuit to model the inference dynamics and try to explain the observed phenomena of ICL. In detail, we divide ICL inference into 3 major operations: (1) Summarize: LMs encode every input text (demonstrations and queries) into linear representation in the hidden states with sufficient information to solve ICL tasks. (2) Semantics Merge: LMs merge the encoded representations of demonstrations with their corresponding label tokens to produce joint representations of labels and demonstrations. (3) Feature Retrieval and Copy: LMs search the joint representations similar to the query representation on a task subspace, and copy the searched representations into the query. Then, language model heads capture these copied label representations to a certain extent and decode them into predicted labels. The proposed inference circuit successfully captured many phenomena observed during the ICL process, making it a comprehensive and practical explanation of the ICL inference process. Moreover, ablation analysis by disabling the proposed steps seriously damages the ICL performance, suggesting the proposed inference circuit is a dominating mechanism. Additionally, we confirm and list some bypass mechanisms that solve ICL tasks in parallel with the proposed circuit.

Despite the rapid recent progress in creating accurate and compact in-context learners, most recent work focuses on in-context learning (ICL) for tasks in English. However, the ability to interact with users of languages outside English presents a great potential for broadening the applicability of language technologies to non-English speakers. In this work, we collect the infrastructure necessary for training and evaluation of ICL in a selection of Slavic languages: Czech, Polish, and Russian. We link a diverse set of datasets and cast these into a unified instructional format through a set of transformations and newly-crafted templates written purely in target languages. Using the newly-curated dataset, we evaluate a set of the most recent in-context learners and compare their results to the supervised baselines. Finally, we train, evaluate and publish a set of in-context learning models that we train on the collected resources and compare their performance to previous work. We find that ICL models tuned in English are also able to learn some tasks from non-English contexts, but multilingual instruction fine-tuning consistently improves the ICL ability. We also find that the massive multitask training can be outperformed by single-task training in the target language, uncovering the potential for specializing in-context learners to the language(s) of their application.

Automated medical image analysis systems often require large amounts of training data with high quality labels, which are difficult and time consuming to generate. This paper introduces Radiology Object in COntext version 2 (ROCOv2), a multimodal dataset consisting of radiological images and associated medical concepts and captions extracted from the PMC Open Access subset. It is an updated version of the ROCO dataset published in 2018, and adds 35,705 new images added to PMC since 2018. It further provides manually curated concepts for imaging modalities with additional anatomical and directional concepts for X-rays. The dataset consists of 79,789 images and has been used, with minor modifications, in the concept detection and caption prediction tasks of ImageCLEFmedical Caption 2023. The dataset is suitable for training image annotation models based on image-caption pairs, or for multi-label image classification using Unified Medical Language System (UMLS) concepts provided with each image. In addition, it can serve for pre-training of medical domain models, and evaluation of deep learning models for multi-task learning.

Despite recent advancements in Large Language Models (LLMs), their performance on tasks involving long contexts remains sub-optimal. In-Context Learning (ICL) with few-shot examples may be an appealing solution to enhance LLM performance in this scenario; However, naively adding ICL examples with long context introduces challenges, including substantial token overhead added for each few-shot example and context mismatch between the demonstrations and the target query. In this work, we propose to automatically generate few-shot examples for long context QA tasks by recycling contexts. Specifically, given a long input context (1-3k tokens) and a query, we generate additional query-output pairs from the given context as few-shot examples, while introducing the context only once. This ensures that the demonstrations are leveraging the same context as the target query while only adding a small number of tokens to the prompt. We further enhance each demonstration by instructing the model to explicitly identify the relevant paragraphs before the answer, which improves performance while providing fine-grained attribution to the answer source. We apply our method on multiple LLMs and obtain substantial improvements (+23\% on average across models) on various QA datasets with long context, especially when the answer lies within the middle of the context. Surprisingly, despite introducing only single-hop ICL examples, LLMs also successfully generalize to multi-hop long-context QA using our approach.

Electronic health record (EHR) systems are used extensively throughout the healthcare domain. However, data interchangeability between EHR systems is limited due to the use of different coding standards across systems. Existing methods of mapping coding standards based on manual human experts mapping, dictionary mapping, symbolic NLP and classification are unscalable and cannot accommodate large scale EHR datasets. In this work, we present Text2Node, a cross-domain mapping system capable of mapping medical phrases to concepts in a large taxonomy (such as SNOMED CT). The system is designed to generalize from a limited set of training samples and map phrases to elements of the taxonomy that are not covered by training data. As a result, our system is scalable, robust to wording variants between coding systems and can output highly relevant concepts when no exact concept exists in the target taxonomy. Text2Node operates in three main stages: first, the lexicon is mapped to word embeddings; second, the taxonomy is vectorized using node embeddings; and finally, the mapping function is trained to connect the two embedding spaces. We compared multiple algorithms and architectures for each stage of the training, including GloVe and FastText word embeddings, CNN and Bi-LSTM mapping functions, and node2vec for node embeddings. We confirmed the robustness and generalisation properties of Text2Node by mapping ICD-9-CM Diagnosis phrases to SNOMED CT and by zero-shot training at comparable accuracy. This system is a novel methodological contribution to the task of normalizing and linking phrases to a taxonomy, advancing data interchangeability in healthcare. When applied, the system can use electronic health records to generate an embedding that incorporates taxonomical medical knowledge to improve clinical predictive models.

Objectives: We aim to dynamically retrieve informative demonstrations, enhancing in-context learning in multimodal large language models (MLLMs) for disease classification. Methods: We propose a Retrieval-Augmented In-Context Learning (RAICL) framework, which integrates retrieval-augmented generation (RAG) and in-context learning (ICL) to adaptively select demonstrations with similar disease patterns, enabling more effective ICL in MLLMs. Specifically, RAICL examines embeddings from diverse encoders, including ResNet, BERT, BioBERT, and ClinicalBERT, to retrieve appropriate demonstrations, and constructs conversational prompts optimized for ICL. We evaluated the framework on two real-world multi-modal datasets (TCGA and IU Chest X-ray), assessing its performance across multiple MLLMs (Qwen, Llava, Gemma), embedding strategies, similarity metrics, and varying numbers of demonstrations. Results: RAICL consistently improved classification performance. Accuracy increased from 0.7854 to 0.8368 on TCGA and from 0.7924 to 0.8658 on IU Chest X-ray. Multi-modal inputs outperformed single-modal ones, with text-only inputs being stronger than images alone. The richness of information embedded in each modality will determine which embedding model can be used to get better results. Few-shot experiments showed that increasing the number of retrieved examples further enhanced performance. Across different similarity metrics, Euclidean distance achieved the highest accuracy while cosine similarity yielded better macro-F1 scores. RAICL demonstrated consistent improvements across various MLLMs, confirming its robustness and versatility. Conclusions: RAICL provides an efficient and scalable approach to enhance in-context learning in MLLMs for multimodal disease classification.

In-context learning (ICL) is a type of prompting where a transformer model operates on a sequence of (input, output) examples and performs inference on-the-fly. In this work, we formalize in-context learning as an algorithm learning problem where a transformer model implicitly constructs a hypothesis function at inference-time. We first explore the statistical aspects of this abstraction through the lens of multitask learning: We obtain generalization bounds for ICL when the input prompt is (1) a sequence of i.i.d. (input, label) pairs or (2) a trajectory arising from a dynamical system. The crux of our analysis is relating the excess risk to the stability of the algorithm implemented by the transformer. We characterize when transformer/attention architecture provably obeys the stability condition and also provide empirical verification. For generalization on unseen tasks, we identify an inductive bias phenomenon in which the transfer learning risk is governed by the task complexity and the number of MTL tasks in a highly predictable manner. Finally, we provide numerical evaluations that (1) demonstrate transformers can indeed implement near-optimal algorithms on classical regression problems with i.i.d. and dynamic data, (2) provide insights on stability, and (3) verify our theoretical predictions.

The challenges faced by neural networks on tabular data are well-documented and have hampered the progress of tabular foundation models. Techniques leveraging in-context learning (ICL) have shown promise here, allowing for dynamic adaptation to unseen data. ICL can provide predictions for entirely new datasets without further training or hyperparameter tuning, therefore providing very fast inference when encountering a novel task. However, scaling ICL for tabular data remains an issue: approaches based on large language models cannot efficiently process numeric tables, and tabular-specific techniques have not been able to effectively harness the power of real data to improve performance and generalization. We are able to overcome these challenges by training tabular-specific ICL-based architectures on real data with self-supervised learning and retrieval, combining the best of both worlds. Our resulting model -- the Tabular Discriminative Pre-trained Transformer (TabDPT) -- achieves state-of-the-art performance on the CC18 (classification) and CTR23 (regression) benchmarks with no task-specific fine-tuning, demonstrating the adapatability and speed of ICL once the model is pre-trained. TabDPT also demonstrates strong scaling as both model size and amount of available data increase, pointing towards future improvements simply through the curation of larger tabular pre-training datasets and training larger models.

Tabular in-context learning (ICL) has recently achieved state-of-the-art (SOTA) performance on several tabular prediction tasks. Previously restricted to classification problems on small tables, recent advances such as TabPFN and TabICL have extended its use to larger datasets. While being architecturally efficient and well-adapted to tabular data structures, current table-native ICL architectures, being trained exclusively on synthetic data, do not fully leverage the rich semantics and world knowledge contained in real-world tabular data. On another end of this spectrum, tabular ICL models based on pretrained large language models such as TabuLa-8B integrate deep semantic understanding and world knowledge but are only able to make use of a small amount of context due to inherent architectural limitations. With the aim to combine the best of both these worlds, we introduce ConTextTab, integrating semantic understanding and alignment into a table-native ICL framework. By employing specialized embeddings for different data modalities and by training on large-scale real-world tabular data, our model is competitive with SOTA across a broad set of benchmarks while setting a new standard on the semantically rich CARTE benchmark.

In this work, we explore the mechanism of in-context learning (ICL) on out-of-distribution (OOD) tasks that were not encountered during training. To achieve this, we conduct synthetic experiments where the objective is to learn OOD mathematical functions through ICL using a GPT-2 model. We reveal that Transformers may struggle to learn OOD task functions through ICL. Specifically, ICL performance resembles implementing a function within the pretraining hypothesis space and optimizing it with gradient descent based on the in-context examples. Additionally, we investigate ICL's well-documented ability to learn unseen abstract labels in context. We demonstrate that such ability only manifests in the scenarios without distributional shifts and, therefore, may not serve as evidence of new-task-learning ability. Furthermore, we assess ICL's performance on OOD tasks when the model is pretrained on multiple tasks. Both empirical and theoretical analyses demonstrate the existence of the low-test-error preference of ICL, where it tends to implement the pretraining function that yields low test error in the testing context. We validate this through numerical experiments. This new theoretical result, combined with our empirical findings, elucidates the mechanism of ICL in addressing OOD tasks.

Context: Test-driven development (TDD) is a widely employed software development practice that involves developing test cases based on requirements prior to writing the code. Although various methods for automated test case generation have been proposed, they are not specifically tailored for TDD, where requirements instead of code serve as input. Objective: In this paper, we introduce a text-to-testcase generation approach based on a large language model (GPT-3.5) that is fine-tuned on our curated dataset with an effective prompt design. Method: Our approach involves enhancing the capabilities of basic GPT-3.5 for text-to-testcase generation task that is fine-tuned on our curated dataset with an effective prompting design. We evaluated the effectiveness of our approach using a span of five large-scale open-source software projects. Results: Our approach generated 7k test cases for open source projects, achieving 78.5% syntactic correctness, 67.09% requirement alignment, and 61.7% code coverage, which substantially outperforms all other LLMs (basic GPT-3.5, Bloom, and CodeT5). In addition, our ablation study demonstrates the substantial performance improvement of the fine-tuning and prompting components of the GPT-3.5 model. Conclusions: These findings lead us to conclude that fine-tuning and prompting should be considered in the future when building a language model for the text-to-testcase generation task

As structured data are often insufficient, labels need to be extracted from free text in electronic health records when developing models for clinical information retrieval and decision support systems. One of the most important contextual properties in clinical text is negation, which indicates the absence of findings. We aimed to improve large scale extraction of labels by comparing three methods for negation detection in Dutch clinical notes. We used the Erasmus Medical Center Dutch Clinical Corpus to compare a rule-based method based on ContextD, a biLSTM model using MedCAT and (finetuned) RoBERTa-based models. We found that both the biLSTM and RoBERTa models consistently outperform the rule-based model in terms of F1 score, precision and recall. In addition, we systematically categorized the classification errors for each model, which can be used to further improve model performance in particular applications. Combining the three models naively was not beneficial in terms of performance. We conclude that the biLSTM and RoBERTa-based models in particular are highly accurate accurate in detecting clinical negations, but that ultimately all three approaches can be viable depending on the use case at hand.

In-context learning (ICL) approaches typically leverage prompting to condition decoder-only language model generation on reference information. Just-in-time processing of a context is inefficient due to the quadratic cost of self-attention operations, and caching is desirable. However, caching transformer states can easily require almost as much space as the model parameters. When the right context isn't known in advance, caching ICL can be challenging. This work addresses these limitations by introducing models that, inspired by the encoder-decoder architecture, use cross-attention to condition generation on reference text without the prompt. More precisely, we leverage pre-trained decoder-only models and only train a small number of added layers. We use Question-Answering (QA) as a testbed to evaluate the ability of our models to perform conditional generation and observe that they outperform ICL, are comparable to fine-tuned prompted LLMs, and drastically reduce the space footprint relative to standard KV caching by two orders of magnitude.

Generating synthetic text addresses the challenge of data availability in privacy-sensitive domains such as healthcare. This study explores the applicability of synthetic data in real-world medical settings. We introduce MedSyn, a novel medical text generation framework that integrates large language models with a Medical Knowledge Graph (MKG). We use MKG to sample prior medical information for the prompt and generate synthetic clinical notes with GPT-4 and fine-tuned LLaMA models. We assess the benefit of synthetic data through application in the ICD code prediction task. Our research indicates that synthetic data can increase the classification accuracy of vital and challenging codes by up to 17.8% compared to settings without synthetic data. Furthermore, to provide new data for further research in the healthcare domain, we present the largest open-source synthetic dataset of clinical notes for the Russian language, comprising over 41k samples covering 219 ICD-10 codes.

In this work, we present a manually annotated corpus for Adverse Event (AE) extraction from discharge summaries of elderly patients, a population often underrepresented in clinical NLP resources. The dataset includes 14 clinically significant AEs-such as falls, delirium, and intracranial haemorrhage, along with contextual attributes like negation, diagnosis type, and in-hospital occurrence. Uniquely, the annotation schema supports both discontinuous and overlapping entities, addressing challenges rarely tackled in prior work. We evaluate multiple models using FlairNLP across three annotation granularities: fine-grained, coarse-grained, and coarse-grained with negation. While transformer-based models (e.g., BERT-cased) achieve strong performance on document-level coarse-grained extraction (F1 = 0.943), performance drops notably for fine-grained entity-level tasks (e.g., F1 = 0.675), particularly for rare events and complex attributes. These results demonstrate that despite high-level scores, significant challenges remain in detecting underrepresented AEs and capturing nuanced clinical language. Developed within a Trusted Research Environment (TRE), the dataset is available upon request via DataLoch and serves as a robust benchmark for evaluating AE extraction methods and supporting future cross-dataset generalisation.

In-context learning (ICL) is an important capability of Large Language Models (LLMs), enabling these models to dynamically adapt based on specific, in-context exemplars, thereby improving accuracy and relevance. However, LLM's responses may leak the sensitive private information contained in in-context exemplars. To address this challenge, we propose Differentially Private In-context Learning (DP-ICL), a general paradigm for privatizing ICL tasks. The key idea for DP-ICL paradigm is generating differentially private responses through a noisy consensus among an ensemble of LLM's responses based on disjoint exemplar sets. Based on the general paradigm of DP-ICL, we instantiate several techniques showing how to privatize ICL for text classification and language generation. We evaluate DP-ICL on four text classification benchmarks and two language generation tasks, and our empirical results show that DP-ICL achieves a strong utility-privacy tradeoff.

Follow-up question generation is an essential feature of dialogue systems as it can reduce conversational ambiguity and enhance modeling complex interactions. Conversational contexts often pose core NLP challenges such as (i) extracting relevant information buried in fragmented data sources, and (ii) modeling parallel thought processes. These two challenges occur frequently in medical dialogue as a doctor asks questions based not only on patient utterances but also their prior EHR data and current diagnostic hypotheses. Asking medical questions in asynchronous conversations compounds these issues as doctors can only rely on static EHR information to motivate follow-up questions. To address these challenges, we introduce FollowupQ, a novel framework for enhancing asynchronous medical conversation. FollowupQ is a multi-agent framework that processes patient messages and EHR data to generate personalized follow-up questions, clarifying patient-reported medical conditions. FollowupQ reduces requisite provider follow-up communications by 34%. It also improves performance by 17% and 5% on real and synthetic data, respectively. We also release the first public dataset of asynchronous medical messages with linked EHR data alongside 2,300 follow-up questions written by clinical experts for the wider NLP research community.

Machine learning (ML) approaches have demonstrated promising results in a wide range of healthcare applications. Data plays a crucial role in developing ML-based healthcare systems that directly affect people's lives. Many of the ethical issues surrounding the use of ML in healthcare stem from structural inequalities underlying the way we collect, use, and handle data. Developing guidelines to improve documentation practices regarding the creation, use, and maintenance of ML healthcare datasets is therefore of critical importance. In this work, we introduce Healthsheet, a contextualized adaptation of the original datasheet questionnaire ~gebru2018datasheets for health-specific applications. Through a series of semi-structured interviews, we adapt the datasheets for healthcare data documentation. As part of the Healthsheet development process and to understand the obstacles researchers face in creating datasheets, we worked with three publicly-available healthcare datasets as our case studies, each with different types of structured data: Electronic health Records (EHR), clinical trial study data, and smartphone-based performance outcome measures. Our findings from the interviewee study and case studies show 1) that datasheets should be contextualized for healthcare, 2) that despite incentives to adopt accountability practices such as datasheets, there is a lack of consistency in the broader use of these practices 3) how the ML for health community views datasheets and particularly Healthsheets as diagnostic tool to surface the limitations and strength of datasets and 4) the relative importance of different fields in the datasheet to healthcare concerns.

Linking clinical narratives to standardized vocabularies and coding systems is a key component of unlocking the information in medical text for analysis. However, many domains of medical concepts lack well-developed terminologies that can support effective coding of medical text. We present a framework for developing natural language processing (NLP) technologies for automated coding of under-studied types of medical information, and demonstrate its applicability via a case study on physical mobility function. Mobility is a component of many health measures, from post-acute care and surgical outcomes to chronic frailty and disability, and is coded in the International Classification of Functioning, Disability, and Health (ICF). However, mobility and other types of functional activity remain under-studied in medical informatics, and neither the ICF nor commonly-used medical terminologies capture functional status terminology in practice. We investigated two data-driven paradigms, classification and candidate selection, to link narrative observations of mobility to standardized ICF codes, using a dataset of clinical narratives from physical therapy encounters. Recent advances in language modeling and word embedding were used as features for established machine learning models and a novel deep learning approach, achieving a macro F-1 score of 84% on linking mobility activity reports to ICF codes. Both classification and candidate selection approaches present distinct strengths for automated coding in under-studied domains, and we highlight that the combination of (i) a small annotated data set; (ii) expert definitions of codes of interest; and (iii) a representative text corpus is sufficient to produce high-performing automated coding systems. This study has implications for the ongoing growth of NLP tools for a variety of specialized applications in clinical care and research.

Large language models (LLMs) demonstrate emergent in-context learning capabilities, where they adapt to new tasks based on example demonstrations. However, in-context learning has seen limited effectiveness in many settings, is difficult to quantitatively control and takes up context window space. To overcome these limitations, we propose an alternative approach that recasts in-context learning as in-context vectors (ICV). Using ICV has two steps. We first use a forward pass on demonstration examples to create the in-context vector from the latent embedding of the LLM. This vector captures essential information about the intended task. On a new query, instead of adding demonstrations to the prompt, we shift the latent states of the LLM using the ICV. The ICV approach has several benefits: 1) it enables the LLM to more effectively follow the demonstration examples; 2) it's easy to control by adjusting the magnitude of the ICV; 3) it reduces the length of the prompt by removing the in-context demonstrations; 4) ICV is computationally much more efficient than fine-tuning. We demonstrate that ICV achieves better performance compared to standard in-context learning and fine-tuning on diverse tasks including safety, style transfer, role-playing and formatting. Moreover, we show that we can flexibly teach LLM to simultaneously follow different types of instructions by simple vector arithmetics on the corresponding ICVs.

Various design settings for in-context learning (ICL), such as the choice and order of the in-context examples, can bias a model toward a particular prediction without being reflective of an understanding of the task. While many studies discuss these design choices, there have been few systematic investigations into categorizing them and mitigating their impact. In this work, we define a typology for three types of label biases in ICL for text classification: vanilla-label bias, context-label bias, and domain-label bias (which we conceptualize and detect for the first time). Our analysis demonstrates that prior label bias calibration methods fall short of addressing all three types of biases. Specifically, domain-label bias restricts LLMs to random-level performance on many tasks regardless of the choice of in-context examples. To mitigate the effect of these biases, we propose a simple bias calibration method that estimates a language model's label bias using random in-domain words from the task corpus. After controlling for this estimated bias when making predictions, our novel domain-context calibration significantly improves the ICL performance of GPT-J and GPT-3 on a wide range of tasks. The gain is substantial on tasks with large domain-label bias (up to 37% in Macro-F1). Furthermore, our results generalize to models with different scales, pretraining methods, and manually-designed task instructions, showing the prevalence of label biases in ICL.

Background: Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated tools, and other challenges hinder the full utilisation of NLP for EHRs. Various Machine Learning (ML), Deep Learning (DL) and NLP techniques are studied and compared to understand the limitations and opportunities in this space comprehensively. Methodology: After screening 261 articles from 11 databases, we included 127 papers for full-text review covering seven categories of articles: 1) medical note classification, 2) clinical entity recognition, 3) text summarisation, 4) deep learning (DL) and transfer learning architecture, 5) information extraction, 6) Medical language translation and 7) other NLP applications. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result and Discussion: EHR was the most commonly used data type among the selected articles, and the datasets were primarily unstructured. Various ML and DL methods were used, with prediction or classification being the most common application of ML or DL. The most common use cases were: the International Classification of Diseases, Ninth Revision (ICD-9) classification, clinical note analysis, and named entity recognition (NER) for clinical descriptions and research on psychiatric disorders. Conclusion: We find that the adopted ML models were not adequately assessed. In addition, the data imbalance problem is quite important, yet we must find techniques to address this underlining problem. Future studies should address key limitations in studies, primarily identifying Lupus Nephritis, Suicide Attempts, perinatal self-harmed and ICD-9 classification.

Large Language Models have demonstrated remarkable performance across various tasks, exhibiting the capacity to swiftly acquire new skills, such as through In-Context Learning (ICL) with minimal demonstration examples. In this work, we present a comprehensive framework for investigating Multimodal ICL (M-ICL) in the context of Large Multimodal Models. We consider the best open-source multimodal models (e.g., IDEFICS, OpenFlamingo) and a wide range of multimodal tasks. Our study unveils several noteworthy findings: (1) M-ICL primarily relies on text-driven mechanisms, showing little to no influence from the image modality. (2) When used with advanced-ICL strategy (like RICES), M-ICL is not better than a simple strategy based on majority voting over context examples. Moreover, we identify several biases and limitations of M-ICL that warrant consideration prior to deployment. Code available at https://gitlab.com/folbaeni/multimodal-icl

In-context learning (ICL) is one of the most powerful and most unexpected capabilities to emerge in recent transformer-based large language models (LLMs). Yet the mechanisms that underlie it are poorly understood. In this paper, we demonstrate that comparable ICL capabilities can be acquired by an alternative sequence prediction learning method using clone-structured causal graphs (CSCGs). Moreover, a key property of CSCGs is that, unlike transformer-based LLMs, they are {\em interpretable}, which considerably simplifies the task of explaining how ICL works. Specifically, we show that it uses a combination of (a) learning template (schema) circuits for pattern completion, (b) retrieving relevant templates in a context-sensitive manner, and (c) rebinding of novel tokens to appropriate slots in the templates. We go on to marshall evidence for the hypothesis that similar mechanisms underlie ICL in LLMs. For example, we find that, with CSCGs as with LLMs, different capabilities emerge at different levels of overparameterization, suggesting that overparameterization helps in learning more complex template (schema) circuits. By showing how ICL can be achieved with small models and datasets, we open up a path to novel architectures, and take a vital step towards a more general understanding of the mechanics behind this important capability.

Agentic systems offer a potential path to solve complex clinical tasks through collaboration among specialized agents, augmented by tool use and external knowledge bases. Nevertheless, for chest X-ray (CXR) interpretation, prevailing methods remain limited: (i) reasoning is frequently neither clinically interpretable nor aligned with guidelines, reflecting mere aggregation of tool outputs; (ii) multimodal evidence is insufficiently fused, yielding text-only rationales that are not visually grounded; and (iii) systems rarely detect or resolve cross-tool inconsistencies and provide no principled verification mechanisms. To bridge the above gaps, we present RadAgents, a multi-agent framework for CXR interpretation that couples clinical priors with task-aware multimodal reasoning. In addition, we integrate grounding and multimodal retrieval-augmentation to verify and resolve context conflicts, resulting in outputs that are more reliable, transparent, and consistent with clinical practice.

In-Context Learning (ICL) enhances the performance of large language models (LLMs) with demonstrations. However, obtaining these demonstrations primarily relies on manual effort. In most real-world scenarios, users are often unwilling or unable to provide such demonstrations. Inspired by the human analogy, we explore a new ICL paradigm CrossICL to study how to utilize existing source task demonstrations in the ICL for target tasks, thereby obtaining reliable guidance without any additional manual effort. To explore this, we first design a two-stage alignment strategy to mitigate the interference caused by gaps across tasks, as the foundation for our experimental exploration. Based on it, we conduct comprehensive exploration of CrossICL, with 875 NLP tasks from the Super-NI benchmark and six types of LLMs, including GPT-4o. Experimental results demonstrate the effectiveness of CrossICL and provide valuable insights on questions like the criteria for selecting cross-task demonstrations, as well as the types of task-gap-induced interference in CrossICL.

In-context learning (ICL) enables large language models (LLMs) to perform new tasks using only a few demonstrations. In Named Entity Recognition (NER), demonstrations are typically selected based on semantic similarity to the test instance, ignoring training labels and resulting in suboptimal performance. We introduce DEER, a new method that leverages training labels through token-level statistics to improve ICL performance. DEER first enhances example selection with a label-guided, token-based retriever that prioritizes tokens most informative for entity recognition. It then prompts the LLM to revisit error-prone tokens, which are also identified using label statistics, and make targeted corrections. Evaluated on five NER datasets using four different LLMs, DEER consistently outperforms existing ICL methods and approaches the performance of supervised fine-tuning. Further analysis shows its effectiveness on both seen and unseen entities and its robustness in low-resource settings.

Large Language Models (LLMs) are increasingly used as powerful tools for a plethora of natural language processing (NLP) applications. A recent innovation, in-context learning (ICL), enables LLMs to learn new tasks by supplying a few examples in the prompt during inference time, thereby eliminating the need for model fine-tuning. While LLMs have been utilized in several applications, their applicability in explaining the behavior of other models remains relatively unexplored. Despite the growing number of new explanation techniques, many require white-box access to the model and/or are computationally expensive, highlighting a need for next-generation post hoc explainers. In this work, we present the first framework to study the effectiveness of LLMs in explaining other predictive models. More specifically, we propose a novel framework encompassing multiple prompting strategies: i) Perturbation-based ICL, ii) Prediction-based ICL, iii) Instruction-based ICL, and iv) Explanation-based ICL, with varying levels of information about the underlying ML model and the local neighborhood of the test sample. We conduct extensive experiments with real-world benchmark datasets to demonstrate that LLM-generated explanations perform on par with state-of-the-art post hoc explainers using their ability to leverage ICL examples and their internal knowledge in generating model explanations. On average, across four datasets and two ML models, we observe that LLMs identify the most important feature with 72.19% accuracy, opening up new frontiers in explainable artificial intelligence (XAI) to explore LLM-based explanation frameworks.

Ensuring the accuracy of responses provided by large language models (LLMs) is crucial, particularly in clinical settings where incorrect information may directly impact patient health. To address this challenge, we construct K-QA, a dataset containing 1,212 patient questions originating from real-world conversations held on K Health (an AI-driven clinical platform). We employ a panel of in-house physicians to answer and manually decompose a subset of K-QA into self-contained statements. Additionally, we formulate two NLI-based evaluation metrics approximating recall and precision: (1) comprehensiveness, measuring the percentage of essential clinical information in the generated answer and (2) hallucination rate, measuring the number of statements from the physician-curated response contradicted by the LLM answer. Finally, we use K-QA along with these metrics to evaluate several state-of-the-art models, as well as the effect of in-context learning and medically-oriented augmented retrieval schemes developed by the authors. Our findings indicate that in-context learning improves the comprehensiveness of the models, and augmented retrieval is effective in reducing hallucinations. We make K-QA available to to the community to spur research into medically accurate NLP applications.

Extracting patient information from unstructured text is a critical task in health decision-support and clinical research. Large language models (LLMs) have shown the potential to accelerate clinical curation via few-shot in-context learning, in contrast to supervised learning which requires much more costly human annotations. However, despite drastic advances in modern LLMs such as GPT-4, they still struggle with issues regarding accuracy and interpretability, especially in mission-critical domains such as health. Here, we explore a general mitigation framework using self-verification, which leverages the LLM to provide provenance for its own extraction and check its own outputs. This is made possible by the asymmetry between verification and generation, where the latter is often much easier than the former. Experimental results show that our method consistently improves accuracy for various LLMs in standard clinical information extraction tasks. Additionally, self-verification yields interpretations in the form of a short text span corresponding to each output, which makes it very efficient for human experts to audit the results, paving the way towards trustworthy extraction of clinical information in resource-constrained scenarios. To facilitate future research in this direction, we release our code and prompts.

Code completion aims at speeding up code writing by recommending to developers the next tokens they are likely to type. Deep Learning (DL) models pushed the boundaries of code completion by redefining what these coding assistants can do: We moved from predicting few code tokens to automatically generating entire functions. One important factor impacting the performance of DL-based code completion techniques is the context provided as input. With "context" we refer to what the model knows about the code to complete. In a simple scenario, the DL model might be fed with a partially implemented function to complete. In this case, the context is represented by the incomplete function and, based on it, the model must generate a prediction. It is however possible to expand such a context to include additional information, like the whole source code file containing the function to complete, which could be useful to boost the prediction performance. In this work, we present an empirical study investigating how the performance of a DL-based code completion technique is affected by different contexts. We experiment with 8 types of contexts and their combinations. These contexts include: (i) coding contexts, featuring information extracted from the code base in which the code completion is invoked (e.g., code components structurally related to the one to "complete"); (ii) process context, with information aimed at depicting the current status of the project in which a code completion task is triggered (e.g., a textual representation of open issues relevant for the code to complete); and (iii) developer contexts, capturing information about the developer invoking the code completion (e.g., the APIs frequently used). Our results show that additional contextual information can benefit the performance of DL-based code completion, with relative improvements up to +22% in terms of correct predictions.

The long-standing dominance of gradient-boosted decision trees on tabular data is currently challenged by tabular foundation models using In-Context Learning (ICL): setting the training data as context for the test data and predicting in a single forward pass without parameter updates. While the very recent TabPFNv2 foundation model (2025) excels on tables with up to 10K samples, its alternating column- and row-wise attentions make handling large training sets computationally prohibitive. So, can ICL be effectively scaled and deliver a benefit for larger tables? We introduce TabICL, a tabular foundation model for classification, pretrained on synthetic datasets with up to 60K samples and capable of handling 500K samples on affordable resources. This is enabled by a novel two-stage architecture: a column-then-row attention mechanism to build fixed-dimensional embeddings of rows, followed by a transformer for efficient ICL. Across 200 classification datasets from the TALENT benchmark, TabICL is on par with TabPFNv2 while being systematically faster (up to 10 times), and significantly outperforms all other approaches. On 56 datasets with over 10K samples, TabICL surpasses both TabPFNv2 and CatBoost, demonstrating the potential of ICL for large data.

In-context learning (ICL) -- the capacity of a model to infer and apply abstract patterns from examples provided within its input -- has been extensively studied in large language models trained for next-token prediction on human text. In fact, prior work often attributes this emergent behavior to distinctive statistical properties in human language. This raises a fundamental question: can ICL arise organically in other sequence domains purely through large-scale predictive training? To explore this, we turn to genomic sequences, an alternative symbolic domain rich in statistical structure. Specifically, we study the Evo2 genomic model, trained predominantly on next-nucleotide (A/T/C/G) prediction, at a scale comparable to mid-sized LLMs. We develop a controlled experimental framework comprising symbolic reasoning tasks instantiated in both linguistic and genomic forms, enabling direct comparison of ICL across genomic and linguistic models. Our results show that genomic models, like their linguistic counterparts, exhibit log-linear gains in pattern induction as the number of in-context demonstrations increases. To the best of our knowledge, this is the first evidence of organically emergent ICL in genomic sequences, supporting the hypothesis that ICL arises as a consequence of large-scale predictive modeling over rich data. These findings extend emergent meta-learning beyond language, pointing toward a unified, modality-agnostic view of in-context learning.

In the rapidly advancing field of artificial intelligence, software development has emerged as a key area of innovation. Despite the plethora of general-purpose AI assistants available, their effectiveness diminishes in complex, domain-specific scenarios. Noting this limitation, both the academic community and industry players are relying on contextualized coding AI assistants. These assistants surpass general-purpose AI tools by integrating proprietary, domain-specific knowledge, offering precise and relevant solutions. Our study focuses on the initial experiences of 62 participants who used a contextualized coding AI assistant -- named StackSpot AI -- in a controlled setting. According to the participants, the assistants' use resulted in significant time savings, easier access to documentation, and the generation of accurate codes for internal APIs. However, challenges associated with the knowledge sources necessary to make the coding assistant access more contextual information as well as variable responses and limitations in handling complex codes were observed. The study's findings, detailing both the benefits and challenges of contextualized AI assistants, underscore their potential to revolutionize software development practices, while also highlighting areas for further refinement.

In-context learning refers to the emerging ability of large language models (LLMs) to perform a target task without additional training, utilizing demonstrations of the task. Recent studies aim to enhance in-context learning performance by selecting more useful demonstrations. However, they overlook the presence of inevitable noisy labels in task demonstrations that arise during the labeling process in the real-world. In this paper, we propose a new task, in-context learning with noisy labels, which aims to solve real-world problems for in-context learning where labels in task demonstrations would be corrupted. Moreover, we propose a new method and baseline methods for the new task, inspired by studies in learning with noisy labels. Through experiments, we demonstrate that our proposed method can serve as a safeguard against performance degradation in in-context learning caused by noisy labels.

Foundation model development attracts a rapidly expanding body of contributors, scientists, and applications. To help shape responsible development practices, we introduce the Foundation Model Development Cheatsheet: a growing collection of 250+ tools and resources spanning text, vision, and speech modalities. We draw on a large body of prior work to survey resources (e.g. software, documentation, frameworks, guides, and practical tools) that support informed data selection, processing, and understanding, precise and limitation-aware artifact documentation, efficient model training, advance awareness of the environmental impact from training, careful model evaluation of capabilities, risks, and claims, as well as responsible model release, licensing and deployment practices. We hope this curated collection of resources helps guide more responsible development. The process of curating this list, enabled us to review the AI development ecosystem, revealing what tools are critically missing, misused, or over-used in existing practices. We find that (i) tools for data sourcing, model evaluation, and monitoring are critically under-serving ethical and real-world needs, (ii) evaluations for model safety, capabilities, and environmental impact all lack reproducibility and transparency, (iii) text and particularly English-centric analyses continue to dominate over multilingual and multi-modal analyses, and (iv) evaluation of systems, rather than just models, is needed so that capabilities and impact are assessed in context.

Although existing model editing methods perform well in recalling exact edit facts, they often struggle in complex scenarios that require deeper semantic understanding rather than mere knowledge regurgitation. Leveraging the strong contextual reasoning abilities of large language models (LLMs), in-context learning (ICL) becomes a promising editing method by comprehending edit information through context encoding. However, this method is constrained by the limited context window of LLMs, leading to degraded performance and efficiency as the number of edits increases. To overcome this limitation, we propose InComeS, a flexible framework that enhances LLMs' ability to process editing contexts through explicit compression and selection mechanisms. Specifically, InComeS compresses each editing context into the key-value (KV) cache of a special gist token, enabling efficient handling of multiple edits without being restricted by the model's context window. Furthermore, specialized cross-attention modules are added to dynamically select the most relevant information from the gist pools, enabling adaptive and effective utilization of edit information. We conduct experiments on diverse model editing benchmarks with various editing formats, and the results demonstrate the effectiveness and efficiency of our method.

The proliferation of harmful online content--e.g., toxicity, spam, and negative sentiment--demands robust and adaptable moderation systems. However, prevailing moderation systems are centralized and task-specific, offering limited transparency and neglecting diverse user preferences--an approach ill-suited for privacy-sensitive or decentralized environments. We propose a novel framework that leverages in-context learning (ICL) with foundation models to unify the detection of toxicity, spam, and negative sentiment across binary, multi-class, and multi-label settings. Crucially, our approach enables lightweight personalization, allowing users to easily block new categories, unblock existing ones, or extend detection to semantic variations through simple prompt-based interventions--all without model retraining. Extensive experiments on public benchmarks (TextDetox, UCI SMS, SST2) and a new, annotated Mastodon dataset reveal that: (i) foundation models achieve strong cross-task generalization, often matching or surpassing task-specific fine-tuned models; (ii) effective personalization is achievable with as few as one user-provided example or definition; and (iii) augmenting prompts with label definitions or rationales significantly enhances robustness to noisy, real-world data. Our work demonstrates a definitive shift beyond one-size-fits-all moderation, establishing ICL as a practical, privacy-preserving, and highly adaptable pathway for the next generation of user-centric content safety systems. To foster reproducibility and facilitate future research, we publicly release our code on GitHub and the annotated Mastodon dataset on Hugging Face.

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

We focus on the Source Free Object Detection (SFOD) problem, when source data is unavailable during adaptation, and the model must adapt to the unlabeled target domain. In medical imaging, several approaches have leveraged a semi-supervised student-teacher architecture to bridge domain discrepancy. Context imbalance in labeled training data and significant domain shifts between domains can lead to biased teacher models that produce inaccurate pseudolabels, degrading the student model's performance and causing a mode collapse. Class imbalance, particularly when one class significantly outnumbers another, leads to contextual bias. To tackle the problem of context bias and the significant performance drop of the student model in the SFOD setting, we introduce Grounded Teacher (GT) as a standard framework. In this study, we model contextual relationships using a dedicated relational context module and leverage it to mitigate inherent biases in the model. This approach enables us to apply augmentations to closely related classes, across and within domains, enhancing the performance of underrepresented classes while keeping the effect on dominant classes minimal. We further improve the quality of predictions by implementing an expert foundational branch to supervise the student model. We validate the effectiveness of our approach in mitigating context bias under the SFOD setting through experiments on three medical datasets supported by comprehensive ablation studies. All relevant resources, including preprocessed data, trained model weights, and code, are publicly available at this https://github.com/Tajamul21/Grounded_Teacher.

The emergent ability of Large Language Models to use a small number of examples to learn to perform in novel domains and tasks, also called in-context learning (ICL). In this work, we show that a much smaller model can be trained to perform ICL by fine-tuning towards a specialized training objective, exemplified on the task of domain adaptation for neural machine translation. With this capacity for ICL, the model can take advantage of relevant few-shot examples to adapt its output towards the domain. We compare the quality of this domain adaptation to traditional supervised techniques and ICL with a 40B-parameter Large Language Model. Our approach allows efficient batch inference on a mix of domains and outperforms state-of-the-art baselines in terms of both translation quality and immediate adaptation rate, i.e. the ability to reproduce a specific term after being shown a single example.

Recent advances in large language models have led to renewed interest in natural language processing in healthcare using the free text of clinical notes. One distinguishing characteristic of clinical notes is their long time span over multiple long documents. The unique structure of clinical notes creates a new design choice: when the context length for a language model predictor is limited, which part of clinical notes should we choose as the input? Existing studies either choose the inputs with domain knowledge or simply truncate them. We propose a framework to analyze the sections with high predictive power. Using MIMIC-III, we show that: 1) predictive power distribution is different between nursing notes and discharge notes and 2) combining different types of notes could improve performance when the context length is large. Our findings suggest that a carefully selected sampling function could enable more efficient information extraction from clinical notes.

We present a corpus of 5,000 richly annotated abstracts of medical articles describing clinical randomized controlled trials. Annotations include demarcations of text spans that describe the Patient population enrolled, the Interventions studied and to what they were Compared, and the Outcomes measured (the `PICO' elements). These spans are further annotated at a more granular level, e.g., individual interventions within them are marked and mapped onto a structured medical vocabulary. We acquired annotations from a diverse set of workers with varying levels of expertise and cost. We describe our data collection process and the corpus itself in detail. We then outline a set of challenging NLP tasks that would aid searching of the medical literature and the practice of evidence-based medicine.

Large language models (LLMs), such as GPT-3 and ChatGPT, have demonstrated remarkable results in various natural language processing (NLP) tasks with in-context learning, which involves inference based on a few demonstration examples. Despite their successes in NLP tasks, no investigation has been conducted to assess the ability of LLMs to perform document information extraction (DIE) using in-context learning. Applying LLMs to DIE poses two challenges: the modality and task gap. To this end, we propose a simple but effective in-context learning framework called ICL-D3IE, which enables LLMs to perform DIE with different types of demonstration examples. Specifically, we extract the most difficult and distinct segments from hard training documents as hard demonstrations for benefiting all test instances. We design demonstrations describing relationships that enable LLMs to understand positional relationships. We introduce formatting demonstrations for easy answer extraction. Additionally, the framework improves diverse demonstrations by updating them iteratively. Our experiments on three widely used benchmark datasets demonstrate that the ICL-D3IE framework enables Davinci-003/ChatGPT to achieve superior performance when compared to previous pre-trained methods fine-tuned with full training in both the in-distribution (ID) setting and in the out-of-distribution (OOD) setting. Code is available at https://github.com/MAEHCM/ICL-D3IE.

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Clinical natural language processing requires methods that can address domain-specific challenges, such as complex medical terminology and clinical contexts. Recently, large language models (LLMs) have shown promise in this domain. Yet, their direct deployment can lead to privacy issues and are constrained by resources. To address this challenge, we delve into synthetic clinical text generation using LLMs for clinical NLP tasks. We propose an innovative, resource-efficient approach, ClinGen, which infuses knowledge into the process. Our model involves clinical knowledge extraction and context-informed LLM prompting. Both clinical topics and writing styles are drawn from external domain-specific knowledge graphs and LLMs to guide data generation. Our extensive empirical study across 7 clinical NLP tasks and 16 datasets reveals that ClinGen consistently enhances performance across various tasks, effectively aligning the distribution of real datasets and significantly enriching the diversity of generated training instances. We will publish our code and all the generated data in https://github.com/ritaranx/ClinGen.

In-context learning is a promising paradigm that utilizes in-context examples as prompts for the predictions of large language models. These prompts are crucial for achieving strong performance. However, since the prompts need to be sampled from a large volume of annotated examples, finding the right prompt may result in high annotation costs. To address this challenge, this paper introduces an influence-driven selective annotation method that aims to minimize annotation costs while improving the quality of in-context examples. The essence of our method is to select a pivotal subset from a large-scale unlabeled data pool to annotate for the subsequent sampling of prompts. Specifically, a directed graph is first constructed to represent unlabeled data. Afterward, the influence of candidate unlabeled subsets is quantified with a diffusion process. A simple yet effective greedy algorithm for unlabeled data selection is lastly introduced. It iteratively selects the data if it provides a maximum marginal gain with respect to quantified influence. Compared with previous efforts on selective annotations, our influence-driven method works in an end-to-end manner, avoids an intractable explicit balance between data diversity and representativeness, and enjoys theoretical support. Experiments confirm the superiority of the proposed method on various benchmarks, achieving better performance under lower time consumption during subset selection. The project page is available at https://skzhang1.github.io/IDEAL/.

Accurate coding of tumor diagnoses with ICD-10-GM and ICD-O-3 is essential for structured cancer documentation in Germany. Smaller open-weight LLMs are appealing for privacy-preserving automation but often struggle with coding accuracy in German-language contexts. This study investigates whether instruction-based fine-tuning on public datasets improves the coding accuracy of open-weight LLMs for German tumor diagnosis texts. The evaluation uses coded diagnoses from the local tumor documentation system as test data. In a systematic data quality assessment, the upper limit for ICD-10 coding performance was estimated at 60-79% for exact and 81-94% for partial (three-character codes only) derivation. As training data, over 500,000 question-answer pairs were created based on the ICD-10-GM, ICD-O-3, and OPS catalogues. Eight open-weight models from the Qwen, Llama, and Mistral families (7-70 B parameters) were fine-tuned. ICD-10-GM accuracy rose from 1.4-24% to 41-58%, and partial accuracy from 31-74% to 73-83%. The accuracy of ICD-O-3 topography coding also improved but started and remained considerably lower with an exact accuracy of 22-40% and a partial accuracy of 56-67% after fine-tuning. Malformed code outputs dropped to 0% for all models. Tumor-diagnosis recognition reached 99%. Accuracy correlated positively with model size, but gaps between small and large models narrowed after fine-tuning. The reasoning mode in Qwen3 generally yielded a lower performance than fine-tuning and was over 100 times slower. Our findings highlight the potential of leveraging public catalogues to build instruction datasets that improve LLMs in medical documentation tasks. The complete training dataset and the best-performing checkpoints of the fine-tuned models are available from https://huggingface.co/datasets/stefan-m-lenz/ICDOPS-QA-2024.

This paper introduces two significant contributions to address the issue of grounding claims in a given context. Grounding means that given a context (document) and a claim, there's at least one supportive evidence for the claim in the document. We will introduce Paladin-mini, a compact (3.8B parameters) open-source classifier model (used for labeling data as grounded or ungrounded) engineered for robust performance in real-world scenarios, and the grounding-benchmark, a new evaluation dataset designed to assess performance on critical reasoning tasks. We'll also demonstrate the results of Paladin-mini with benchmarks against the current State-of-the-art and share clear and reproducible results.

This technical report introduces a Named Clinical Entity Recognition Benchmark for evaluating language models in healthcare, addressing the crucial natural language processing (NLP) task of extracting structured information from clinical narratives to support applications like automated coding, clinical trial cohort identification, and clinical decision support. The leaderboard provides a standardized platform for assessing diverse language models, including encoder and decoder architectures, on their ability to identify and classify clinical entities across multiple medical domains. A curated collection of openly available clinical datasets is utilized, encompassing entities such as diseases, symptoms, medications, procedures, and laboratory measurements. Importantly, these entities are standardized according to the Observational Medical Outcomes Partnership (OMOP) Common Data Model, ensuring consistency and interoperability across different healthcare systems and datasets, and a comprehensive evaluation of model performance. Performance of models is primarily assessed using the F1-score, and it is complemented by various assessment modes to provide comprehensive insights into model performance. The report also includes a brief analysis of models evaluated to date, highlighting observed trends and limitations. By establishing this benchmarking framework, the leaderboard aims to promote transparency, facilitate comparative analyses, and drive innovation in clinical entity recognition tasks, addressing the need for robust evaluation methods in healthcare NLP.

As model context lengths continue to increase, the number of demonstrations that can be provided in-context approaches the size of entire training datasets. We study the behavior of in-context learning (ICL) at this extreme scale on multiple datasets and models. We show that, for many datasets with large label spaces, performance continues to increase with hundreds or thousands of demonstrations. We contrast this with example retrieval and finetuning: example retrieval shows excellent performance at low context lengths but has diminished gains with more demonstrations; finetuning is more data hungry than ICL but can sometimes exceed long-context ICL performance with additional data. We use this ICL setting as a testbed to study several properties of both in-context learning and long-context models. We show that long-context ICL is less sensitive to random input shuffling than short-context ICL, that grouping of same-label examples can negatively impact performance, and that the performance boosts we see do not arise from cumulative gain from encoding many examples together. We conclude that although long-context ICL can be surprisingly effective, most of this gain comes from attending back to similar examples rather than task learning.

Large Language Models (LLMs), although powerful in general domains, often perform poorly on domain-specific tasks like medical question answering (QA). Moreover, they tend to function as "black-boxes," making it challenging to modify their behavior. Addressing this, our study delves into model editing utilizing in-context learning, aiming to improve LLM responses without the need for fine-tuning or retraining. Specifically, we propose a comprehensive retrieval strategy to extract medical facts from an external knowledge base, and then we incorporate them into the query prompt for the LLM. Focusing on medical QA using the MedQA-SMILE dataset, we evaluate the impact of different retrieval models and the number of facts provided to the LLM. Notably, our edited Vicuna model exhibited an accuracy improvement from 44.46% to 48.54%. This work underscores the potential of model editing to enhance LLM performance, offering a practical approach to mitigate the challenges of black-box LLMs.

Motivated by in-context learning (ICL) capabilities of Large Language models (LLMs), multimodal LLMs with additional visual modality are also exhibited with similar ICL abilities when multiple image-text pairs are provided as demonstrations. However, relatively less work has been done to investigate the principles behind how and why multimodal ICL works. We conduct a systematic and principled evaluation of multimodal ICL for models of different scales on a broad spectrum of new yet critical tasks. Through perturbations over different modality information, we show that modalities matter differently across tasks in multimodal ICL. Considering such modality impact, we further utilize modality-driven demonstration strategies to boost ICL performance. We also identify that demonstration selection is closely related to the models' ability to capture task inductive biases from multimodal ICL. Our principled analysis provides a comprehensive way of understanding the role of demonstrations in multimodal in-context learning, and sheds light on effectively improving multimodal ICL on a wide range of tasks even if those tasks are not seen in or even contradict pretraining data.

As the production of and reliance on datasets to produce automated decision-making systems (ADS) increases, so does the need for processes for evaluating and interrogating the underlying data. After launching the Dataset Nutrition Label in 2018, the Data Nutrition Project has made significant updates to the design and purpose of the Label, and is launching an updated Label in late 2020, which is previewed in this paper. The new Label includes context-specific Use Cases &Alerts presented through an updated design and user interface targeted towards the data scientist profile. This paper discusses the harm and bias from underlying training data that the Label is intended to mitigate, the current state of the work including new datasets being labeled, new and existing challenges, and further directions of the work, as well as Figures previewing the new label.

The emergence of in-context learning (ICL) is potentially attributed to two major abilities: task recognition (TR) for recognizing the task from demonstrations and utilizing pre-trained priors, and task learning (TL) for learning from demonstrations. However, relationships between the two abilities and how such relationships affect the emergence of ICL is unclear. In this paper, we take the first step by examining the pre-training dynamics of the emergence of ICL. With carefully designed metrics, we find that these two abilities are, in fact, competitive during pre-training. Moreover, we observe a strong negative correlation between the competition and ICL performance. Further analysis of common pre-training factors (i.e., model size, dataset size, and data curriculum) demonstrates possible ways to manage the competition. Based on these insights, we propose a simple yet effective method to better integrate these two abilities for ICL at inference time. Through adaptive ensemble learning, the performance of ICL can be significantly boosted, enabling two small models to outperform a larger one with more than twice the parameters. The code is available at https://github.com/RUCAIBox/Competitive-ICL.

Hospital information systems (HIS) have become an essential part of healthcare institutions and now incorporate prescribing support software. Prescription support software allows for structured information capture, which improves the safety, appropriateness and efficiency of prescriptions and reduces the number of adverse drug events (ADEs). However, such a system increases the amount of time physicians spend at a computer entering information instead of providing medical care. In addition, any new visiting clinician must learn to manage complex interfaces since each HIS has its own interfaces. In this paper, we present a natural language interface for e-prescribing software in the form of a spoken dialogue system accessible on a smartphone. This system allows prescribers to record their prescriptions verbally, a form of interaction closer to their usual practice. The system extracts the formal representation of the prescription ready to be checked by the prescribing software and uses the dialogue to request mandatory information, correct errors or warn of particular situations. Since, to the best of our knowledge, there is no existing voice-based prescription dialogue system, we present the system developed in a low-resource environment, focusing on dialogue modeling, semantic extraction and data augmentation. The system was evaluated in the wild with 55 participants. This evaluation showed that our system has an average prescription time of 66.15 seconds for physicians and 35.64 seconds for other experts, and a task success rate of 76\% for physicians and 72\% for other experts. All evaluation data were recorded and annotated to form PxCorpus, the first spoken drug prescription corpus that has been made fully available to the community (https://doi.org/10.5281/zenodo.6524162).

Large language models (LLMs) are rapidly transitioning into medical clinical use, yet their reliability under realistic, multi-turn interactions remains poorly understood. Existing evaluation frameworks typically assess single-turn question answering under idealized conditions, overlooking the complexities of medical consultations where conflicting input, misleading context, and authority influence are common. We introduce MedQA-Followup, a framework for systematically evaluating multi-turn robustness in medical question answering. Our approach distinguishes between shallow robustness (resisting misleading initial context) and deep robustness (maintaining accuracy when answers are challenged across turns), while also introducing an indirect-direct axis that separates contextual framing (indirect) from explicit suggestion (direct). Using controlled interventions on the MedQA dataset, we evaluate five state-of-the-art LLMs and find that while models perform reasonably well under shallow perturbations, they exhibit severe vulnerabilities in multi-turn settings, with accuracy dropping from 91.2% to as low as 13.5% for Claude Sonnet 4. Counterintuitively, indirect, context-based interventions are often more harmful than direct suggestions, yielding larger accuracy drops across models and exposing a significant vulnerability for clinical deployment. Further compounding analyses reveal model differences, with some showing additional performance drops under repeated interventions while others partially recovering or even improving. These findings highlight multi-turn robustness as a critical but underexplored dimension for safe and reliable deployment of medical LLMs.