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Apr 22

CUPCase: Clinically Uncommon Patient Cases and Diagnoses Dataset

Medical benchmark datasets significantly contribute to developing Large Language Models (LLMs) for medical knowledge extraction, diagnosis, summarization, and other uses. Yet, current benchmarks are mainly derived from exam questions given to medical students or cases described in the medical literature, lacking the complexity of real-world patient cases that deviate from classic textbook abstractions. These include rare diseases, uncommon presentations of common diseases, and unexpected treatment responses. Here, we construct Clinically Uncommon Patient Cases and Diagnosis Dataset (CUPCase) based on 3,562 real-world case reports from BMC, including diagnoses in open-ended textual format and as multiple-choice options with distractors. Using this dataset, we evaluate the ability of state-of-the-art LLMs, including both general-purpose and Clinical LLMs, to identify and correctly diagnose a patient case, and test models' performance when only partial information about cases is available. Our findings show that general-purpose GPT-4o attains the best performance in both the multiple-choice task (average accuracy of 87.9%) and the open-ended task (BERTScore F1 of 0.764), outperforming several LLMs with a focus on the medical domain such as Meditron-70B and MedLM-Large. Moreover, GPT-4o was able to maintain 87% and 88% of its performance with only the first 20% of tokens of the case presentation in multiple-choice and free text, respectively, highlighting the potential of LLMs to aid in early diagnosis in real-world cases. CUPCase expands our ability to evaluate LLMs for clinical decision support in an open and reproducible manner.

Planning Anything with Rigor: General-Purpose Zero-Shot Planning with LLM-based Formalized Programming

While large language models (LLMs) have recently demonstrated strong potential in solving planning problems, there is a trade-off between flexibility and complexity. LLMs, as zero-shot planners themselves, are still not capable of directly generating valid plans for complex planning problems such as multi-constraint or long-horizon tasks. On the other hand, many frameworks aiming to solve complex planning problems often rely on task-specific preparatory efforts, such as task-specific in-context examples and pre-defined critics/verifiers, which limits their cross-task generalization capability. In this paper, we tackle these challenges by observing that the core of many planning problems lies in optimization problems: searching for the optimal solution (best plan) with goals subject to constraints (preconditions and effects of decisions). With LLMs' commonsense, reasoning, and programming capabilities, this opens up the possibilities of a universal LLM-based approach to planning problems. Inspired by this observation, we propose LLMFP, a general-purpose framework that leverages LLMs to capture key information from planning problems and formally formulate and solve them as optimization problems from scratch, with no task-specific examples needed. We apply LLMFP to 9 planning problems, ranging from multi-constraint decision making to multi-step planning problems, and demonstrate that LLMFP achieves on average 83.7% and 86.8% optimal rate across 9 tasks for GPT-4o and Claude 3.5 Sonnet, significantly outperforming the best baseline (direct planning with OpenAI o1-preview) with 37.6% and 40.7% improvements. We also validate components of LLMFP with ablation experiments and analyzed the underlying success and failure reasons.

ToolBridge: An Open-Source Dataset to Equip LLMs with External Tool Capabilities

Through the integration of external tools, large language models (LLMs) such as GPT-4o and Llama 3.1 significantly expand their functional capabilities, evolving from elementary conversational agents to general-purpose assistants. We argue that the primary drivers of these advancements are the quality and diversity of the training data. However, the existing LLMs with external tool integration provide only limited transparency regarding their datasets and data collection methods, which has led to the initiation of this research. Specifically, in this paper, our objective is to elucidate the detailed process involved in constructing datasets that empower LLMs to effectively learn how to utilize external tools and make this information available to the public through the introduction of ToolBridge. ToolBridge proposes to employ a collection of general open-access datasets as its raw dataset pool and applies a series of strategies to identify appropriate data entries from the pool for external tool API insertions. By supervised fine-tuning on these curated data entries, LLMs can invoke external tools in appropriate contexts to boost their predictive accuracy, particularly for basic functions including data processing, numerical computation, and factual retrieval. Our experiments rigorously isolates model architectures and training configurations, focusing exclusively on the role of data. The experimental results indicate that LLMs trained on ToolBridge demonstrate consistent performance improvements on both standard benchmarks and custom evaluation datasets. All the associated code and data will be open-source at https://github.com/CharlesPikachu/ToolBridge, promoting transparency and facilitating the broader community to explore approaches for equipping LLMs with external tools capabilities.

LLMs-in-the-Loop Part 2: Expert Small AI Models for Anonymization and De-identification of PHI Across Multiple Languages

The rise of chronic diseases and pandemics like COVID-19 has emphasized the need for effective patient data processing while ensuring privacy through anonymization and de-identification of protected health information (PHI). Anonymized data facilitates research without compromising patient confidentiality. This paper introduces expert small AI models developed using the LLM-in-the-loop methodology to meet the demand for domain-specific de-identification NER models. These models overcome the privacy risks associated with large language models (LLMs) used via APIs by eliminating the need to transmit or store sensitive data. More importantly, they consistently outperform LLMs in de-identification tasks, offering superior performance and reliability. Our de-identification NER models, developed in eight languages (English, German, Italian, French, Romanian, Turkish, Spanish, and Arabic) achieved f1-micro score averages of 0.966, 0.975, 0.976, 0.970, 0.964, 0.974, 0.978, and 0.953 respectively. These results establish them as the most accurate healthcare anonymization solutions, surpassing existing small models and even general-purpose LLMs such as GPT-4o. While Part-1 of this series introduced the LLM-in-the-loop methodology for bio-medical document translation, this second paper showcases its success in developing cost-effective expert small NER models in de-identification tasks. Our findings lay the groundwork for future healthcare AI innovations, including biomedical entity and relation extraction, demonstrating the value of specialized models for domain-specific challenges.

How Well Does GPT-4V(ision) Adapt to Distribution Shifts? A Preliminary Investigation

In machine learning, generalization against distribution shifts -- where deployment conditions diverge from the training scenarios -- is crucial, particularly in fields like climate modeling, biomedicine, and autonomous driving. The emergence of foundation models, distinguished by their extensive pretraining and task versatility, has led to an increased interest in their adaptability to distribution shifts. GPT-4V(ision) acts as the most advanced publicly accessible multimodal foundation model, with extensive applications across various domains, including anomaly detection, video understanding, image generation, and medical diagnosis. However, its robustness against data distributions remains largely underexplored. Addressing this gap, this study rigorously evaluates GPT-4V's adaptability and generalization capabilities in dynamic environments, benchmarking against prominent models like CLIP and LLaVA. We delve into GPT-4V's zero-shot generalization across 13 diverse datasets spanning natural, medical, and molecular domains. We further investigate its adaptability to controlled data perturbations and examine the efficacy of in-context learning as a tool to enhance its adaptation. Our findings delineate GPT-4V's capability boundaries in distribution shifts, shedding light on its strengths and limitations across various scenarios. Importantly, this investigation contributes to our understanding of how AI foundation models generalize to distribution shifts, offering pivotal insights into their adaptability and robustness. Code is publicly available at https://github.com/jameszhou-gl/gpt-4v-distribution-shift.

Improving Autonomous AI Agents with Reflective Tree Search and Self-Learning

Autonomous agents have demonstrated significant potential in automating complex multistep decision-making tasks. However, even state-of-the-art vision-language models (VLMs), such as GPT-4o, still fall short of human-level performance, particularly in intricate web environments and long-horizon planning tasks. To address these limitations, we introduce Reflective Monte Carlo Tree Search (R-MCTS), a novel test-time algorithm designed to enhance the ability of AI agents, e.g., powered by GPT-4o, to explore decision space on the fly. R-MCTS extends traditional MCTS by 1) incorporating contrastive reflection, allowing agents to learn from past interactions and dynamically improve their search efficiency; and 2) using multi-agent debate to provide reliable state evaluation. Moreover, we improve the agent's performance by fine-tuning GPT-4o through self-learning, using R-MCTS generated tree traversals without any human-provided labels. On the challenging VisualWebArena benchmark, our GPT-4o-based R-MCTS agent achieves a 6% to 30% relative improvement across various tasks compared to the previous state-of-the-art. Additionally, we show that the knowledge gained from test-time search can be effectively transferred back to GPT-4o via fine-tuning. The fine-tuned GPT-4o matches 97% of R-MCTS's performance while reducing compute usage by a factor of four at test time. Furthermore, qualitative results reveal that the fine-tuned GPT-4o model demonstrates the ability to explore the environment, evaluate a state, and backtrack to viable ones when it detects that the current state cannot lead to success. Moreover, our work demonstrates the compute scaling properties in both training - data collection with R-MCTS - and testing time. These results suggest a promising research direction to enhance VLMs' reasoning and planning capabilities for agentic applications via test-time search and self-learning.

Comparing Human and LLM Generated Code: The Jury is Still Out!

Much is promised in relation to AI-supported software development. However, there has been limited evaluation effort in the research domain aimed at validating the true utility of such techniques, especially when compared to human coding outputs. We bridge this gap, where a benchmark dataset comprising 72 distinct software engineering tasks is used to compare the effectiveness of large language models (LLMs) and human programmers in producing Python software code. GPT-4 is used as a representative LLM, where for the code generated by humans and this LLM, we evaluate code quality and adherence to Python coding standards, code security and vulnerabilities, code complexity and functional correctness. We use various static analysis benchmarks, including Pylint, Radon, Bandit and test cases. Among the notable outcomes, results show that human-generated code recorded higher ratings for adhering to coding standards than GPT-4. We observe security flaws in code generated by both humans and GPT-4, however, code generated by humans shows a greater variety of problems, but GPT-4 code included more severe outliers. Our results show that although GPT-4 is capable of producing coding solutions, it frequently produces more complex code that may need more reworking to ensure maintainability. On the contrary however, our outcomes show that a higher number of test cases passed for code generated by GPT-4 across a range of tasks than code that was generated by humans. That said, GPT-4 frequently struggles with complex problem-solving that involve in-depth domain knowledge. This study highlights the potential utility of LLMs for supporting software development, however, tasks requiring comprehensive, innovative or unconventional solutions, and careful debugging and error correction seem to be better developed by human programmers. We plot an agenda for the software engineering community.

Fragile Mastery: Are Domain-Specific Trade-Offs Undermining On-Device Language Models?

The application of on-device language models (ODLMs) on resource-constrained edge devices is a multi-dimensional problem that strikes a fine balance between computational effectiveness, memory, power usage, and linguistic capacity across heterogeneous tasks. This holistic study conducts a thorough investigation of the trade-offs between domain-specific optimization and cross-domain robustness, culminating in the proposal of the Generalized Edge Model (GEM), a new architecture that aims to balance specialization and generalization in a harmonious manner. With a rigorous experimental approach testing 47 well-chosen benchmarks in eight domains--healthcare, law, finance, STEM, commonsense, conversational AI, multilingual, and domain-adaptive tasks--we show that conventional optimization techniques decrease target task perplexity by 18-25% but result in a precipitous decline in general-task performance with F1 scores decreasing by 12-29%, as reported by Liu et al. GEM employs a Sparse Cross-Attention Router (SCAR) to dynamically allocate computation to a variable number of computing resources with a cross-domain F1 accuracy of 0.89 on less than 100ms latency across Raspberry Pi 4, Pixel 6, iPhone 13, and bespoke custom neural processing units (NPUs). Compared to GPT-4 Lite, GEM enhances the general-task level by 7% with respect and parity in domain-specific performance. We propose three new measurement tools--Domain Specialization Index (DSI), Generalization Gap (GG), and Cross-Domain Transfer Ratio (CDTR)--which show strong correlation between model compression intensity and brittleness.