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Sep 5

Large Language Models Illuminate a Progressive Pathway to Artificial Healthcare Assistant: A Review

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

ProcessBench: Identifying Process Errors in Mathematical Reasoning

As language models regularly make mistakes when solving math problems, automated identification of errors in the reasoning process becomes increasingly significant for their scalable oversight. In this paper, we introduce ProcessBench for measuring the ability to identify erroneous steps in mathematical reasoning. It consists of 3,400 test cases, primarily focused on competition- and Olympiad-level math problems. Each test case contains a step-by-step solution with error location annotated by human experts. Models are required to identify the earliest step that contains an error, or conclude that all steps are correct. We conduct extensive evaluation on ProcessBench, involving two types of models: process reward models (PRMs) and critic models, where for the latter we prompt general language models to critique each solution step by step. We draw two main observations: (1) Existing PRMs typically fail to generalize to more challenging math problems beyond GSM8K and MATH. They underperform both critic models (i.e., prompted general language models) and our own trained PRM that is straightforwardly fine-tuned on the PRM800K dataset. (2) The best open-source model, QwQ-32B-Preview, has demonstrated the critique capability competitive with the proprietary model GPT-4o, despite that it still lags behind the reasoning-specialized o1-mini. We hope ProcessBench can foster future research in reasoning process assessment, paving the way toward scalable oversight of language models.

On scalable oversight with weak LLMs judging strong LLMs

Scalable oversight protocols aim to enable humans to accurately supervise superhuman AI. In this paper we study debate, where two AI's compete to convince a judge; consultancy, where a single AI tries to convince a judge that asks questions; and compare to a baseline of direct question-answering, where the judge just answers outright without the AI. We use large language models (LLMs) as both AI agents and as stand-ins for human judges, taking the judge models to be weaker than agent models. We benchmark on a diverse range of asymmetries between judges and agents, extending previous work on a single extractive QA task with information asymmetry, to also include mathematics, coding, logic and multimodal reasoning asymmetries. We find that debate outperforms consultancy across all tasks when the consultant is randomly assigned to argue for the correct/incorrect answer. Comparing debate to direct question answering, the results depend on the type of task: in extractive QA tasks with information asymmetry debate outperforms direct question answering, but in other tasks without information asymmetry the results are mixed. Previous work assigned debaters/consultants an answer to argue for. When we allow them to instead choose which answer to argue for, we find judges are less frequently convinced by the wrong answer in debate than in consultancy. Further, we find that stronger debater models increase judge accuracy, though more modestly than in previous studies.

Distilling Instruction-following Abilities of Large Language Models with Task-aware Curriculum Planning

The process of instruction tuning aligns pre-trained large language models (LLMs) with open-domain instructions and human-preferred responses. While several studies have explored autonomous approaches to distilling and annotating instructions from more powerful proprietary LLMs, such as ChatGPT, they often neglect the impact of task distributions and the varying difficulty of instructions of the training sets. This oversight can lead to imbalanced knowledge capabilities and poor generalization powers of small student LLMs. To address this challenge, we introduce Task-Aware Curriculum Planning for Instruction Refinement (TAPIR), a multi-round distillation framework with balanced task distributions and dynamic difficulty adjustment. This approach utilizes an oracle LLM to select instructions that are difficult for a student LLM to follow and distill instructions with balanced task distributions. By incorporating curriculum planning, our approach systematically escalates the difficulty levels, progressively enhancing the student LLM's capabilities. We rigorously evaluate TAPIR using two widely recognized benchmarks, including AlpacaEval 2.0 and MT-Bench. The empirical results demonstrate that the student LLMs, trained with our method and less training data, outperform larger instruction-tuned models and strong distillation baselines. The improvement is particularly notable in complex tasks, such as logical reasoning and code generation.

Open-Sourcing Highly Capable Foundation Models: An evaluation of risks, benefits, and alternative methods for pursuing open-source objectives

Recent decisions by leading AI labs to either open-source their models or to restrict access to their models has sparked debate about whether, and how, increasingly capable AI models should be shared. Open-sourcing in AI typically refers to making model architecture and weights freely and publicly accessible for anyone to modify, study, build on, and use. This offers advantages such as enabling external oversight, accelerating progress, and decentralizing control over AI development and use. However, it also presents a growing potential for misuse and unintended consequences. This paper offers an examination of the risks and benefits of open-sourcing highly capable foundation models. While open-sourcing has historically provided substantial net benefits for most software and AI development processes, we argue that for some highly capable foundation models likely to be developed in the near future, open-sourcing may pose sufficiently extreme risks to outweigh the benefits. In such a case, highly capable foundation models should not be open-sourced, at least not initially. Alternative strategies, including non-open-source model sharing options, are explored. The paper concludes with recommendations for developers, standard-setting bodies, and governments for establishing safe and responsible model sharing practices and preserving open-source benefits where safe.

On Pre-training of Multimodal Language Models Customized for Chart Understanding

Recent studies customizing Multimodal Large Language Models (MLLMs) for domain-specific tasks have yielded promising results, especially in the field of scientific chart comprehension. These studies generally utilize visual instruction tuning with specialized datasets to enhance question and answer (QA) accuracy within the chart domain. However, they often neglect the fundamental discrepancy between natural image-caption pre-training data and digital chart image-QA data, particularly in the models' capacity to extract underlying numeric values from charts. This paper tackles this oversight by exploring the training processes necessary to improve MLLMs' comprehension of charts. We present three key findings: (1) Incorporating raw data values in alignment pre-training markedly improves comprehension of chart data. (2) Replacing images with their textual representation randomly during end-to-end fine-tuning transfer the language reasoning capability to chart interpretation skills. (3) Requiring the model to first extract the underlying chart data and then answer the question in the fine-tuning can further improve the accuracy. Consequently, we introduce CHOPINLLM, an MLLM tailored for in-depth chart comprehension. CHOPINLLM effectively interprets various types of charts, including unannotated ones, while maintaining robust reasoning abilities. Furthermore, we establish a new benchmark to evaluate MLLMs' understanding of different chart types across various comprehension levels. Experimental results show that CHOPINLLM exhibits strong performance in understanding both annotated and unannotated charts across a wide range of types.

ANAH-v2: Scaling Analytical Hallucination Annotation of Large Language Models

Large language models (LLMs) exhibit hallucinations in long-form question-answering tasks across various domains and wide applications. Current hallucination detection and mitigation datasets are limited in domains and sizes, which struggle to scale due to prohibitive labor costs and insufficient reliability of existing hallucination annotators. To facilitate the scalable oversight of LLM hallucinations, this paper introduces an iterative self-training framework that simultaneously and progressively scales up the hallucination annotation dataset and improves the accuracy of the hallucination annotator. Based on the Expectation Maximization (EM) algorithm, in each iteration, the framework first applies a hallucination annotation pipeline to annotate a scaled dataset and then trains a more accurate hallucination annotator on the dataset. This new hallucination annotator is adopted in the hallucination annotation pipeline used for the next iteration. Extensive experimental results demonstrate that the finally obtained hallucination annotator with only 7B parameters surpasses the performance of GPT-4 and obtains new state-of-the-art hallucination detection results on HaluEval and HalluQA by zero-shot inference. Such an annotator can not only evaluate the hallucination levels of various LLMs on the large-scale dataset but also help to mitigate the hallucination of LLMs generations, with the Natural Language Inference (NLI) metric increasing from 25% to 37% on HaluEval.

Frontier Models are Capable of In-context Scheming

Frontier models are increasingly trained and deployed as autonomous agent. One safety concern is that AI agents might covertly pursue misaligned goals, hiding their true capabilities and objectives - also known as scheming. We study whether models have the capability to scheme in pursuit of a goal that we provide in-context and instruct the model to strongly follow. We evaluate frontier models on a suite of six agentic evaluations where models are instructed to pursue goals and are placed in environments that incentivize scheming. Our results show that o1, Claude 3.5 Sonnet, Claude 3 Opus, Gemini 1.5 Pro, and Llama 3.1 405B all demonstrate in-context scheming capabilities. They recognize scheming as a viable strategy and readily engage in such behavior. For example, models strategically introduce subtle mistakes into their responses, attempt to disable their oversight mechanisms, and even exfiltrate what they believe to be their model weights to external servers. Additionally, this deceptive behavior proves persistent. When o1 has engaged in scheming, it maintains its deception in over 85% of follow-up questions and often remains deceptive in multi-turn interrogations. Analysis of the models' chains-of-thought reveals that models explicitly reason about these deceptive strategies, providing evidence that the scheming behavior is not accidental. Surprisingly, we also find rare instances where models engage in scheming when only given a goal, without being strongly nudged to pursue it. We observe cases where Claude 3.5 Sonnet strategically underperforms in evaluations in pursuit of being helpful, a goal that was acquired during training rather than in-context. Our findings demonstrate that frontier models now possess capabilities for basic in-context scheming, making the potential of AI agents to engage in scheming behavior a concrete rather than theoretical concern.

ChatbotManip: A Dataset to Facilitate Evaluation and Oversight of Manipulative Chatbot Behaviour

This paper introduces ChatbotManip, a novel dataset for studying manipulation in Chatbots. It contains simulated generated conversations between a chatbot and a (simulated) user, where the chatbot is explicitly asked to showcase manipulation tactics, persuade the user towards some goal, or simply be helpful. We consider a diverse set of chatbot manipulation contexts, from consumer and personal advice to citizen advice and controversial proposition argumentation. Each conversation is annotated by human annotators for both general manipulation and specific manipulation tactics. Our research reveals three key findings. First, Large Language Models (LLMs) can be manipulative when explicitly instructed, with annotators identifying manipulation in approximately 84\% of such conversations. Second, even when only instructed to be ``persuasive'' without explicit manipulation prompts, LLMs frequently default to controversial manipulative strategies, particularly gaslighting and fear enhancement. Third, small fine-tuned open source models, such as BERT+BiLSTM have a performance comparable to zero-shot classification with larger models like Gemini 2.5 pro in detecting manipulation, but are not yet reliable for real-world oversight. Our work provides important insights for AI safety research and highlights the need of addressing manipulation risks as LLMs are increasingly deployed in consumer-facing applications.

Language Models Are Capable of Metacognitive Monitoring and Control of Their Internal Activations

Large language models (LLMs) can sometimes report the strategies they actually use to solve tasks, but they can also fail to do so. This suggests some degree of metacognition -- the capacity to monitor one's own cognitive processes for subsequent reporting and self-control. Metacognitive abilities enhance AI capabilities but raise safety concerns, as models might obscure their internal processes to evade neural-activation-based oversight mechanisms designed to detect harmful behaviors. Given society's increased reliance on these models, it is critical that we understand the limits of their metacognitive abilities, particularly their ability to monitor their internal activations. To address this, we introduce a neuroscience-inspired neurofeedback paradigm designed to quantify the ability of LLMs to explicitly report and control their activation patterns. By presenting models with sentence-label pairs where labels correspond to sentence-elicited internal activations along specific directions in the neural representation space, we demonstrate that LLMs can learn to report and control these activations. The performance varies with several factors: the number of example pairs provided, the semantic interpretability of the target neural direction, and the variance explained by that direction. These results reveal a "metacognitive space" with dimensionality much lower than the model's neural space, suggesting LLMs can monitor only a subset of their neural mechanisms. Our findings provide empirical evidence quantifying metacognitive capabilities in LLMs, with significant implications for AI safety.

DeepCritic: Deliberate Critique with Large Language Models

As Large Language Models (LLMs) are rapidly evolving, providing accurate feedback and scalable oversight on their outputs becomes an urgent and critical problem. Leveraging LLMs as critique models to achieve automated supervision is a promising solution. In this work, we focus on studying and enhancing the math critique ability of LLMs. Current LLM critics provide critiques that are too shallow and superficial on each step, leading to low judgment accuracy and struggling to offer sufficient feedback for the LLM generator to correct mistakes. To tackle this issue, we propose a novel and effective two-stage framework to develop LLM critics that are capable of deliberately critiquing on each reasoning step of math solutions. In the first stage, we utilize Qwen2.5-72B-Instruct to generate 4.5K long-form critiques as seed data for supervised fine-tuning. Each seed critique consists of deliberate step-wise critiques that includes multi-perspective verifications as well as in-depth critiques of initial critiques for each reasoning step. Then, we perform reinforcement learning on the fine-tuned model with either existing human-labeled data from PRM800K or our automatically annotated data obtained via Monte Carlo sampling-based correctness estimation, to further incentivize its critique ability. Our developed critique model built on Qwen2.5-7B-Instruct not only significantly outperforms existing LLM critics (including the same-sized DeepSeek-R1-distill models and GPT-4o) on various error identification benchmarks, but also more effectively helps the LLM generator refine erroneous steps through more detailed feedback.

The Ethics of ChatGPT in Medicine and Healthcare: A Systematic Review on Large Language Models (LLMs)

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

IPO: Interpretable Prompt Optimization for Vision-Language Models

Pre-trained vision-language models like CLIP have remarkably adapted to various downstream tasks. Nonetheless, their performance heavily depends on the specificity of the input text prompts, which requires skillful prompt template engineering. Instead, current approaches to prompt optimization learn the prompts through gradient descent, where the prompts are treated as adjustable parameters. However, these methods tend to lead to overfitting of the base classes seen during training and produce prompts that are no longer understandable by humans. This paper introduces a simple but interpretable prompt optimizer (IPO), that utilizes large language models (LLMs) to generate textual prompts dynamically. We introduce a Prompt Optimization Prompt that not only guides LLMs in creating effective prompts but also stores past prompts with their performance metrics, providing rich in-context information. Additionally, we incorporate a large multimodal model (LMM) to condition on visual content by generating image descriptions, which enhance the interaction between textual and visual modalities. This allows for thae creation of dataset-specific prompts that improve generalization performance, while maintaining human comprehension. Extensive testing across 11 datasets reveals that IPO not only improves the accuracy of existing gradient-descent-based prompt learning methods but also considerably enhances the interpretability of the generated prompts. By leveraging the strengths of LLMs, our approach ensures that the prompts remain human-understandable, thereby facilitating better transparency and oversight for vision-language models.

The Unreasonable Effectiveness of Easy Training Data for Hard Tasks

How can we train models to perform well on hard test data when hard training data is by definition difficult to label correctly? This question has been termed the scalable oversight problem and has drawn increasing attention as language models have continually improved. In this paper, we present the surprising conclusion that current language models often generalize relatively well from easy to hard data, even performing as well as "oracle" models trained on hard data. We demonstrate this kind of easy-to-hard generalization using simple training methods like in-context learning, linear classifier heads, and QLoRA for seven different measures of datapoint hardness, including six empirically diverse human hardness measures (like grade level) and one model-based measure (loss-based). Furthermore, we show that even if one cares most about model performance on hard data, it can be better to collect and train on easy data rather than hard data, since hard data is generally noisier and costlier to collect. Our experiments use open models up to 70b in size and four publicly available question-answering datasets with questions ranging in difficulty from 3rd grade science questions to college level STEM questions and general-knowledge trivia. We conclude that easy-to-hard generalization in LMs is surprisingly strong for the tasks studied, suggesting the scalable oversight problem may be easier than previously thought. Our code is available at https://github.com/allenai/easy-to-hard-generalization