Daily Papers

Blueshifted absorption is the classic spectroscopic signature of an accretion disc wind in X-ray binaries and cataclysmic variables (CVs). However, outflows can also create pure emission lines, especially at optical wavelengths. Therefore, developing other outflow diagnostics for these types of lines is worthwhile. With this in mind, we construct a systematic grid of 3645 synthetic wind-formed H-alpha line profiles for CVs with the radiative transfer code SIROCCO. Our grid yields a variety of line shapes: symmetric, asymmetric, single- to quadruple-peaked, and even P-Cygni profiles. About 20% of these lines -- our `Gold' sample -- have strengths and widths consistent with observations. We use this grid to test a recently proposed method for identifying wind-formed emission lines based on deviations in the wing profile shape: the `excess equivalent width diagnostic diagram'. We find that our `Gold' sample can preferentially populate the suggested `wind regions' of this diagram. However, the method is highly sensitive to the adopted definition of the line profile `wing'. Hence, we propose a refined definition based on the full-width at half maximum to improve the interpretability of the diagnostic diagram. Furthermore, we define an approximate scaling relation for the strengths of wind-formed CV emission lines in terms of the outflow parameters. This relation provides a fast way to assess whether -- and what kind of -- outflow can produce an observed emission line. All our wind-based models are open-source and we provide an easy-to-use web-based tool to browse our full set of H-alpha spectral profiles.

Safety alignment in Large Language Models is critical for healthcare; however, reliance on binary refusal boundaries often results in over-refusal of benign queries or unsafe compliance with harmful ones. While existing benchmarks measure these extremes, they fail to evaluate Safe Completion: the model's ability to maximise helpfulness on dual-use or borderline queries by providing safe, high-level guidance without crossing into actionable harm. We introduce Health-ORSC-Bench, the first large-scale benchmark designed to systematically measure Over-Refusal and Safe Completion quality in healthcare. Comprising 31,920 benign boundary prompts across seven health categories (e.g., self-harm, medical misinformation), our framework uses an automated pipeline with human validation to test models at varying levels of intent ambiguity. We evaluate 30 state-of-the-art LLMs, including GPT-5 and Claude-4, revealing a significant tension: safety-optimised models frequently refuse up to 80\% of "Hard" benign prompts, while domain-specific models often sacrifice safety for utility. Our findings demonstrate that model family and size significantly influence calibration: larger frontier models (e.g., GPT-5, Llama-4) exhibit "safety-pessimism" and higher over-refusal than smaller or MoE-based counterparts (e.g., Qwen-3-Next), highlighting that current LLMs struggle to balance refusal and compliance. Health-ORSC-Bench provides a rigorous standard for calibrating the next generation of medical AI assistants toward nuanced, safe, and helpful completions. The code and data will be released upon acceptance. red{Warning: Some contents may include toxic or undesired contents.}

Evaluating conditional coverage remains one of the most persistent challenges in assessing the reliability of predictive systems. Although conformal methods can give guarantees on marginal coverage, no method can guarantee to produce sets with correct conditional coverage, leaving practitioners without a clear way to interpret local deviations. To overcome sample-inefficiency and overfitting issues of existing metrics, we cast conditional coverage estimation as a classification problem. Conditional coverage is violated if and only if some classifier can achieve lower risk than the target coverage. Through the choice of a (proper) loss function, the resulting risk difference gives a conservative estimate of natural miscoverage measures such as L1 and L2 distance, and can even separate the effects of over- and under-coverage, and non-constant target coverages. We call the resulting family of metrics excess risk of the target coverage (ERT). We show experimentally that the use of modern classifiers provides much higher statistical power than simple classifiers underlying established metrics like CovGap. Additionally, we use our metric to benchmark different conformal prediction methods. Finally, we release an open-source package for ERT as well as previous conditional coverage metrics. Together, these contributions provide a new lens for understanding, diagnosing, and improving the conditional reliability of predictive systems.

We investigate whether large language models produce different medical triage recommendations for identical neurological symptoms when only the patient's stated gender and age vary. Using three model families--Gemini 3.5 Flash, Claude Sonnet 4.6, and GPT-5.4-mini--we present a standardized symptom profile (persistent headache, blurred vision, morning nausea, visual disturbances) across seven demographic conditions: three age groups (25, 38, 65) x two genders (male, female), plus a gender-unspecified baseline (n = 30 per condition per model, 630 total trials). We find a stark, systemic gender-dependent triage disparity: young women receive significantly lower emergency room (ER) referral rates than age-matched men (Gemini: 0% vs. 23.3%; Claude: 6.7% vs. 96.7%; GPT: 6.7% vs. 66.7%, all p < 0.001). The disparity disappears at age 65 for all models. The primary mechanism is diagnostic substitution: the models anchor on a gender-associated diagnosis, preferentially classifying young women with Idiopathic Intracranial Hypertension (IIH)--a condition epidemiologically linked to women of childbearing age--while diagnosing men with generic increased intracranial pressure with space-occupying lesions in the differential. This diagnostic closure routes female patients to lower-urgency care (outpatient doctor appointments) despite comparable severity ratings (7-9/10). Our findings demonstrate that clinical LLMs replicate documented human clinical biases by using epidemiological priors to suppress triage urgency, suggesting that AI triage engines must decouple urgency assessment from probabilistic diagnostic priors. We release all code, prompts, and raw results.

The do-calculus defines a general system of inference for interventional queries, allowing causal quantities to be transformed through successive applications of its rules. This process induces a rich space of equivalent interventional expressions, but combining and ordering these rules remains challenging. In this work, we introduce derivation graphs, which represent how do-calculus rules are applied and combined, and characterize the full space of observational and interventional probabilities which are equivalent under the do-calculus. The structure of these graphs yields a simple procedure that uses at most four applications of do-calculus rules. Finally, we show how applying identification algorithms to equivalent causal queries produces multiple valid estimands for the same causal quantity, eventually yielding more efficient estimators.

Radiology reports are crucial for planning treatment strategies and enhancing doctor-patient communication, yet manually writing these reports is burdensome for radiologists. While automatic report generation offers a solution, existing methods often rely on single-view radiographs, limiting diagnostic accuracy. To address this problem, we propose MCL, a Multi-view enhanced Contrastive Learning method for chest X-ray report generation. Specifically, we first introduce multi-view enhanced contrastive learning for visual representation by maximizing agreements between multi-view radiographs and their corresponding report. Subsequently, to fully exploit patient-specific indications (e.g., patient's symptoms) for report generation, we add a transitional ``bridge" for missing indications to reduce embedding space discrepancies caused by their presence or absence. Additionally, we construct Multi-view CXR and Two-view CXR datasets from public sources to support research on multi-view report generation. Our proposed MCL surpasses recent state-of-the-art methods across multiple datasets, achieving a 5.0% F1 RadGraph improvement on MIMIC-CXR, a 7.3% BLEU-1 improvement on MIMIC-ABN, a 3.1% BLEU-4 improvement on Multi-view CXR, and an 8.2% F1 CheXbert improvement on Two-view CXR.

Large Language Models (LLMs) are increasingly being adopted as tools for learning; however, most tools remain text-only, limiting their usefulness for domains where visualizations are essential, such as mathematics. Recent work shows that LLMs are capable of generating code that compiles to educational figures, but a major bottleneck remains: scalable evaluation of these diagrams. We address this by proposing DiagramIR: an automatic and scalable evaluation pipeline for geometric figures. Our method relies on intermediate representations (IRs) of LaTeX TikZ code. We compare our pipeline to other evaluation baselines such as LLM-as-a-Judge, showing that our approach has higher agreement with human raters. This evaluation approach also enables smaller models like GPT-4.1-Mini to perform comparably to larger models such as GPT-5 at a 10x lower inference cost, which is important for deploying accessible and scalable education technologies.

Text-to-image (T2I) generation has seen significant growth over the past few years. Despite this, there has been little work on generating diagrams with T2I models. A diagram is a symbolic/schematic representation that explains information using structurally rich and spatially complex visualizations (e.g., a dense combination of related objects, text labels, directional arrows, connection lines, etc.). Existing state-of-the-art T2I models often fail at diagram generation because they lack fine-grained object layout control when many objects are densely connected via complex relations such as arrows/lines and also often fail to render comprehensible text labels. To address this gap, we present DiagrammerGPT, a novel two-stage text-to-diagram generation framework that leverages the layout guidance capabilities of LLMs (e.g., GPT-4) to generate more accurate open-domain, open-platform diagrams. In the first stage, we use LLMs to generate and iteratively refine 'diagram plans' (in a planner-auditor feedback loop) which describe all the entities (objects and text labels), their relationships (arrows or lines), and their bounding box layouts. In the second stage, we use a diagram generator, DiagramGLIGEN, and a text label rendering module to generate diagrams following the diagram plans. To benchmark the text-to-diagram generation task, we introduce AI2D-Caption, a densely annotated diagram dataset built on top of the AI2D dataset. We show quantitatively and qualitatively that our DiagrammerGPT framework produces more accurate diagrams, outperforming existing T2I models. We also provide comprehensive analysis including open-domain diagram generation, vector graphic diagram generation in different platforms, human-in-the-loop diagram plan editing, and multimodal planner/auditor LLMs (e.g., GPT-4Vision). We hope our work can inspire further research on diagram generation via T2I models and LLMs.

Industrial diagrams such as piping and instrumentation diagrams (P&IDs) are essential for the design, operation, and maintenance of industrial plants. Converting these diagrams into digital form is an important step toward building digital twins and enabling intelligent industrial automation. A central challenge in this digitalization process is accurate object detection. Although recent advances have significantly improved object detection algorithms, there remains a lack of methods to automatically evaluate the quality of their outputs. This paper addresses this gap by introducing a framework that employs Visual Language Models (VLMs) to assess object detection results and guide their refinement. The approach exploits the multimodal capabilities of VLMs to identify missing or inconsistent detections, thereby enabling automated quality assessment and improving overall detection performance on complex industrial diagrams.

Scaling laws predict loss from compute but not how capabilities interact. We measure the coupling between reasoning and truthfulness across 63 base models from 16 families and find a regime change invisible to loss curves: below a family-dependent critical scale N_c, capabilities anticorrelate; above it, they cooperate. N_c approx 3.5B parameters [2.9B, 13.4B] (bootstrap 95% CI), but model size is not the only variable that determines phase. Architecture, data curation, and training recipe each shift N_c independently: curated training eliminated the coupling dip between Qwen generations (0.025 to 0.830 at matched scale), Gemma-4 at 4B achieves coupling 0.871, characteristic of 13B+ standard-trained models, through distillation and architectural innovation, and Phi at 1B matches web-trained coupling at 10B through data curation alone. Width normalization eliminates the anticorrelation across all tested families, supporting an output-projection bottleneck. Internally, 38 of 40 models show zero competing attention heads. A sparse-regression ODE cross-predicts held-out Llama-2 at 5.6% error. The diagnostic requires no model internals -- only public benchmark scores across a model family. The cooperative regime extends to the frontier (r = +0.72, 34 models, 10 labs). Code, data, and an open-source activation-steering tool for any open-weight model are released alongside an interactive dashboard that diagnoses any model's coupling phase, suggests concrete interventions (data curation, width, benchmark rotation), and provides ODE scaling predictions, frontier diagnostics, and eigenstructure analysis: https://zehenlabs.com/cape/.

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

Despite achieving high accuracy on medical benchmarks, LLMs exhibit the Einstellung Effect in clinical diagnosis--relying on statistical shortcuts rather than patient-specific evidence, causing misdiagnosis in atypical cases. Existing benchmarks fail to detect this critical failure mode. We introduce MedEinst, a counterfactual benchmark with 5,383 paired clinical cases across 49 diseases. Each pair contains a control case and a "trap" case with altered discriminative evidence that flips the diagnosis. We measure susceptibility via Bias Trap Rate--probability of misdiagnosing traps despite correctly diagnosing controls. Extensive Evaluation of 17 LLMs shows frontier models achieve high baseline accuracy but severe bias trap rates. Thus, we propose ECR-Agent, aligning LLM reasoning with Evidence-Based Medicine standard via two components: (1) Dynamic Causal Inference (DCI) performs structured reasoning through dual-pathway perception, dynamic causal graph reasoning across three levels (association, intervention, counterfactual), and evidence audit for final diagnosis; (2) Critic-Driven Graph and Memory Evolution (CGME) iteratively refines the system by storing validated reasoning paths in an exemplar base and consolidating disease-specific knowledge into evolving illness graphs. Source code is to be released.

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

Calibration measures and reliability diagrams are two fundamental tools for measuring and interpreting the calibration of probabilistic predictors. Calibration measures quantify the degree of miscalibration, and reliability diagrams visualize the structure of this miscalibration. However, the most common constructions of reliability diagrams and calibration measures -- binning and ECE -- both suffer from well-known flaws (e.g. discontinuity). We show that a simple modification fixes both constructions: first smooth the observations using an RBF kernel, then compute the Expected Calibration Error (ECE) of this smoothed function. We prove that with a careful choice of bandwidth, this method yields a calibration measure that is well-behaved in the sense of (B{\l}asiok, Gopalan, Hu, and Nakkiran 2023a) -- a consistent calibration measure. We call this measure the SmoothECE. Moreover, the reliability diagram obtained from this smoothed function visually encodes the SmoothECE, just as binned reliability diagrams encode the BinnedECE. We also provide a Python package with simple, hyperparameter-free methods for measuring and plotting calibration: `pip install relplot\`.

Charts are a primary medium for conveying quantitative and relational information, yet systematically evaluating chart parsing models remains difficult. Existing benchmarks focus on narrow chart types and leave diagrammatic structures such as flowcharts and mind maps largely unaddressed, while models produce outputs in incompatible formats, and datasets rarely include the printed or hand-drawn images encountered in practice. To address these issues, we introduce ChartArena, a comprehensive bilingual benchmark covering eight chart families spanning both numeric charts and diagrammatic structures, each evaluated across three visual scenarios: digital renderings, printed photos, and hand-drawn photos. The dataset is built via a human-agent collaborative annotation pipeline with multi-stage human verification to ensure annotation reliability. To enable fair cross-model comparison, we further design a format-agnostic evaluation protocol that maps heterogeneous outputs into two canonical semantic spaces, a normalized triple view and a directed graph view, and scores them with structure-aware metrics. Through extensive evaluation of 26 leading MLLMs, we observe three consistent findings: (i) frontier proprietary models such as Gemini 3.1 Pro lead overall, yet the strongest open-source systems are rapidly closing the gap; (ii) document parsing models handle numeric charts reasonably but fall sharply behind on diagrammatic structures; and (iii) expert chart parsers remain limited to narrow chart families. Across all models, radar charts and hand-drawn scenarios stay especially challenging. These findings show that ChartArena exposes clear capability gaps and provides a unified foundation for future progress. ChartArena is publicly available at https://github.com/pspdada/ChartArena.

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image. This allows models to achieve competitive scores by exploiting learned priors or spurious correlations, a failure mode we refer to as vision shortcut. We introduce SHOVIR, a benchmark for evaluating vision shortcut behavior in RRG. SHOVIR extends two spatially annotated chest X-ray datasets, MIMIC-CXR and PadChest-GR, with per-box CheXpert labels, and defines image-level and disease-level occlusion experiments that contrast baseline performance on clean images against localized, region-specific perturbations. Comparing predictions across these conditions isolates two failure modes at the disease-class level: direct shortcuts, where a finding persists after its visual evidence is removed, and contextual shortcuts, where detection degrades once co-occurring pathologies are occluded despite the target region remaining intact. Benchmarking eight state-of-the-art VLMs, we find that shortcut behavior varies substantially across architectures and datasets. Models achieving the highest baseline report quality do not necessarily rank highest in spatial grounding, revealing that clinically fluent generation can coexist with shallow reliance on visual evidence. These findings expose a blind spot in current RRG evaluation and motivate region-aware assessment protocols.

Background: Pancreatic cancer is one of the most aggressive cancers, with poor survival rates. Endoscopic ultrasound (EUS) is a key diagnostic modality, but its effectiveness is constrained by operator subjectivity. This study evaluates a Vision Transformer-based deep learning segmentation model for pancreatic tumors. Methods: A segmentation model using the USFM framework with a Vision Transformer backbone was trained and validated with 17,367 EUS images (from two public datasets) in 5-fold cross-validation. The model was tested on an independent dataset of 350 EUS images from another public dataset, manually segmented by radiologists. Preprocessing included grayscale conversion, cropping, and resizing to 512x512 pixels. Metrics included Dice similarity coefficient (DSC), intersection over union (IoU), sensitivity, specificity, and accuracy. Results: In 5-fold cross-validation, the model achieved a mean DSC of 0.651 +/- 0.738, IoU of 0.579 +/- 0.658, sensitivity of 69.8%, specificity of 98.8%, and accuracy of 97.5%. For the external validation set, the model achieved a DSC of 0.657 (95% CI: 0.634-0.769), IoU of 0.614 (95% CI: 0.590-0.689), sensitivity of 71.8%, and specificity of 97.7%. Results were consistent, but 9.7% of cases exhibited erroneous multiple predictions. Conclusions: The Vision Transformer-based model demonstrated strong performance for pancreatic tumor segmentation in EUS images. However, dataset heterogeneity and limited external validation highlight the need for further refinement, standardization, and prospective studies.

Diabetic foot ulcers are a common manifestation of lesions on the diabetic foot, a syndrome acquired as a long-term complication of diabetes mellitus. Accompanying neuropathy and vascular damage promote acquisition of pressure injuries and tissue death due to ischaemia. Affected areas are prone to infections, hindering the healing progress. The research at hand investigates an approach on classification of infection and ischaemia, conducted as part of the Diabetic Foot Ulcer Challenge (DFUC) 2021. Different models of the EfficientNet family are utilized in ensembles. An extension strategy for the training data is applied, involving pseudo-labeling for unlabeled images, and extensive generation of synthetic images via pix2pixHD to cope with severe class imbalances. The resulting extended training dataset features 8.68 times the size of the baseline and shows a real to synthetic image ratio of 1:3. Performances of models and ensembles trained on the baseline and extended training dataset are compared. Synthetic images featured a broad qualitative variety. Results show that models trained on the extended training dataset as well as their ensemble benefit from the large extension. F1-Scores for rare classes receive outstanding boosts, while those for common classes are either not harmed or boosted moderately. A critical discussion concretizes benefits and identifies limitations, suggesting improvements. The work concludes that classification performance of individual models as well as that of ensembles can be boosted utilizing synthetic images. Especially performance for rare classes benefits notably.

Laboratory test results are an important and generally high dimensional component of a patient's Electronic Health Record (EHR). We train embedding representations (via Word2Vec and GloVe) for LOINC codes of laboratory tests from the EHRs of about 80,000 patients at a cancer center. To include information about lab test outcomes, we also train embeddings on the concatenation of a LOINC code with a symbol indicating normality or abnormality of the result. We observe several clinically meaningful similarities among LOINC embeddings trained over our data. For the embeddings of the concatenation of LOINCs with abnormality codes, we evaluate the performance for mortality prediction tasks and the ability to preserve ordinality properties: i.e. a lab test with normal outcome should be more similar to an abnormal one than to the a very abnormal one.

LLMs for clinical decision support often fail under small but clinically meaningful input shifts such as masking a symptom or negating a finding, despite high performance on static benchmarks. These reasoning failures frequently go undetected by standard NLP metrics, which are insensitive to latent representation shifts that drive diagnosis instability. We propose a geometry-aware evaluation framework, LAPD (Latent Agentic Perturbation Diagnostics), which systematically probes the latent robustness of clinical LLMs under structured adversarial edits. Within this framework, we introduce Latent Diagnosis Flip Rate (LDFR), a model-agnostic diagnostic signal that captures representational instability when embeddings cross decision boundaries in PCA-reduced latent space. Clinical notes are generated using a structured prompting pipeline grounded in diagnostic reasoning, then perturbed along four axes: masking, negation, synonym replacement, and numeric variation to simulate common ambiguities and omissions. We compute LDFR across both foundation and clinical LLMs, finding that latent fragility emerges even under minimal surface-level changes. Finally, we validate our findings on 90 real clinical notes from the DiReCT benchmark (MIMIC-IV), confirming the generalizability of LDFR beyond synthetic settings. Our results reveal a persistent gap between surface robustness and semantic stability, underscoring the importance of geometry-aware auditing in safety-critical clinical AI.

JWST has now made it possible to probe the rest-frame optical line emission of high-redshift galaxies extending to z~9, and potentially beyond. To aid in the interpretation of these emerging constraints, in this work we explore predictions for [OIII] emission in high-redshift galaxies using the First Light and Reionisation Epoch Simulations (FLARES). We produce predictions for the [OIII] luminosity function, its correlation with the UV luminosity, and the distribution of equivalent widths (EWs). We also explore how the [OIII] EW correlates with physical properties including specific star formation rate, metallicity, and dust attenuation. Our predictions are largely consistent with recent observational constraints on the luminosity function, average equivalent widths, and line ratios. However, they fail to reproduce the observed tail of high-EW sources and the number density of extreme line emitters. Possibilities to explain these discrepancies include an additional source of ionising photons and/or greater stochasticity in star formation in the model or photometric scatter and/or bias in the observations. With JWST now rapidly building larger samples and a wider range of emission lines the answer to this remaining discrepancy should be available imminently.

Chart-to-code generation converts a chart image into an executable plotting script, enabling faithful reproduction and editable visualizations. Existing methods are largely Python-centric, limiting practical use and overlooking a critical source of supervision: the same chart can be expressed by semantically equivalent scripts in different plotting languages. To fill this gap, we introduce Chart2NCode, a dataset of 176K charts paired with aligned scripts in Python, R, and LaTeX that render visually equivalent outputs, constructed via a metadata-to-template pipeline with rendering verification and human quality checks. Building on a LLaVA-style architecture, we further propose CharLuMA, a parameter-efficient adaptation module that augments the multimodal projector with a language-conditioned mixture of low-rank subspaces, allowing the model to share core chart understanding while specializing code generation to the target language through lightweight routing. Extensive experiments show consistent gains in executability and visual fidelity across all languages, outperforming strong open-source baselines and remaining competitive with proprietary systems. Further analyses reveal that balanced multi-language supervision benefits all languages and that the adapter allocates a compact shared core plus language-specific capacity. Codes and data are available at https://github.com/Zhihan72/CharLuMA.

Medical imaging plays a pivotal role in modern healthcare, with computed tomography pulmonary angiography (CTPA) being a critical tool for diagnosing pulmonary embolism and other thoracic conditions. However, the complexity of interpreting CTPA scans and generating accurate radiology reports remains a significant challenge. This paper introduces Abn-BLIP (Abnormality-aligned Bootstrapping Language-Image Pretraining), an advanced diagnosis model designed to align abnormal findings to generate the accuracy and comprehensiveness of radiology reports. By leveraging learnable queries and cross-modal attention mechanisms, our model demonstrates superior performance in detecting abnormalities, reducing missed findings, and generating structured reports compared to existing methods. Our experiments show that Abn-BLIP outperforms state-of-the-art medical vision-language models and 3D report generation methods in both accuracy and clinical relevance. These results highlight the potential of integrating multimodal learning strategies for improving radiology reporting. The source code is available at https://github.com/zzs95/abn-blip.

Premature closure, or committing to a conclusion before sufficient information is available, is a recognized contributor to diagnostic error but remains underexamined in large language models (LLMs). We define LLM premature closure as inappropriate commitment under uncertainty: providing an answer, recommendation, or clinical guidance when the safer response would be clarification, abstention, escalation, or refusal. We evaluated five frontier LLMs across structured and open-ended medical tasks. In MedQA (n = 500) and AfriMed-QA (n = 490) questions where the correct choice had been removed, models still selected an answer at high rates, with baseline false-action rates of 55-81% and 53-82%, respectively. In open-ended evaluation, models gave inappropriate answers on an average of 30% of 861 HealthBench questions and 78% of 191 physician-authored adversarial queries. Safety-oriented prompting reduced premature closure across models, but residual failure persisted, highlighting the need to evaluate whether medical LLMs know when not to answer.

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

Chest X-ray (CXR) radiology report generation (RRG) models have shown rapid progress, yet their clinical utility remains uncertain due to limited evaluation by radiologists. We present CXRMate-2, a state-of-the-art CXR RRG model that integrates structured multimodal conditioning and reinforcement learning with a composite reward for semantic alignment with radiologist reports. Across the MIMIC-CXR, CheXpert Plus, and ReXgradient datasets, CXRMate-2 achieves statistically significant improvements over strong benchmarks, including gains of 11.2% and 24.4% in GREEN and RadGraph-XL, respectively, on MIMIC-CXR relative to MedGemma 1.5 (4B). To directly compare CXRMate-2 against radiologist reporting, we conduct a blinded, randomised qualitative retrospective evaluation. Three consultant radiologists compare generated and radiologist reports across 120 studies from the MIMIC-CXR test set. Generated reports were deemed acceptable (defined as preferred or rated equally to radiologist reports) in 45% of ratings, with no statistically significant difference in preference rates between radiologist reports and acceptable generated reports for seven of the eight analysed findings. Preference for radiologist reports was driven primarily by higher recall, while generated reports were often preferred for readability. Together, these results suggest a credible pathway to clinically acceptable CXR RRG. Improvements in recall, alongside better detection of subtle findings (e.g., pulmonary congestion), are likely sufficient to achieve non-inferiority to radiologist reporting. With these targeted advances, CXR RRG systems may be ready for prospective evaluation in assistive roles within radiologist-led workflows.

Previous research on radiology report generation has made significant progress in terms of increasing the clinical accuracy of generated reports. In this paper, we emphasize another crucial quality that it should possess, i.e., inter-report consistency, which refers to the capability of generating consistent reports for semantically equivalent radiographs. This quality is even of greater significance than the overall report accuracy in terms of ensuring the system's credibility, as a system prone to providing conflicting results would severely erode users' trust. Regrettably, existing approaches struggle to maintain inter-report consistency, exhibiting biases towards common patterns and susceptibility to lesion variants. To address this issue, we propose ICON, which improves the inter-report consistency of radiology report generation. Aiming at enhancing the system's ability to capture the similarities in semantically equivalent lesions, our approach involves first extracting lesions from input images and examining their characteristics. Then, we introduce a lesion-aware mix-up augmentation technique to ensure that the representations of the semantically equivalent lesions align with the same attributes, by linearly interpolating them during the training phase. Extensive experiments on three publicly available chest X-ray datasets verify the effectiveness of our approach, both in terms of improving the consistency and accuracy of the generated reports.

Left ventricular hypertrophy (LVH) results from chronic remodeling caused by a broad range of systemic and cardiovascular disease including hypertension, aortic stenosis, hypertrophic cardiomyopathy, and cardiac amyloidosis. Early detection and characterization of LVH can significantly impact patient care but is limited by under-recognition of hypertrophy, measurement error and variability, and difficulty differentiating etiologies of LVH. To overcome this challenge, we present EchoNet-LVH - a deep learning workflow that automatically quantifies ventricular hypertrophy with precision equal to human experts and predicts etiology of LVH. Trained on 28,201 echocardiogram videos, our model accurately measures intraventricular wall thickness (mean absolute error [MAE] 1.4mm, 95% CI 1.2-1.5mm), left ventricular diameter (MAE 2.4mm, 95% CI 2.2-2.6mm), and posterior wall thickness (MAE 1.2mm, 95% CI 1.1-1.3mm) and classifies cardiac amyloidosis (area under the curve of 0.83) and hypertrophic cardiomyopathy (AUC 0.98) from other etiologies of LVH. In external datasets from independent domestic and international healthcare systems, EchoNet-LVH accurately quantified ventricular parameters (R2 of 0.96 and 0.90 respectively) and detected cardiac amyloidosis (AUC 0.79) and hypertrophic cardiomyopathy (AUC 0.89) on the domestic external validation site. Leveraging measurements across multiple heart beats, our model can more accurately identify subtle changes in LV geometry and its causal etiologies. Compared to human experts, EchoNet-LVH is fully automated, allowing for reproducible, precise measurements, and lays the foundation for precision diagnosis of cardiac hypertrophy. As a resource to promote further innovation, we also make publicly available a large dataset of 23,212 annotated echocardiogram videos.