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Sep 5

MediConfusion: Can you trust your AI radiologist? Probing the reliability of multimodal medical foundation models

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

Discovering Knowledge Deficiencies of Language Models on Massive Knowledge Base

Large language models (LLMs) possess impressive linguistic capabilities but often fail to faithfully retain factual knowledge, leading to hallucinations and unreliable outputs. Understanding LLMs' knowledge deficiencies by exhaustively evaluating against full-scale knowledge bases is computationally prohibitive, especially for closed-weight models. We propose stochastic error ascent (SEA), a scalable and efficient framework for discovering knowledge deficiencies (errors) in closed-weight LLMs under a strict query budget. Rather than naively probing all knowledge candidates, SEA formulates error discovery as a stochastic optimization process: it iteratively retrieves new high-error candidates by leveraging the semantic similarity to previously observed failures. To further enhance search efficiency and coverage, SEA employs hierarchical retrieval across document and paragraph levels, and constructs a relation directed acyclic graph to model error propagation and identify systematic failure modes. Empirically, SEA uncovers 40.7x more knowledge errors than Automated Capability Discovery and 26.7% more than AutoBencher, while reducing the cost-per-error by 599x and 9x, respectively. Human evaluation confirms the high quality of generated questions, while ablation and convergence analyses validate the contribution of each component in SEA. Further analysis on the discovered errors reveals correlated failure patterns across LLM families and recurring deficits, highlighting the need for better data coverage and targeted fine-tuning in future LLM development.

Automated Optimization Modeling through Expert-Guided Large Language Model Reasoning

Optimization Modeling (OM) is essential for solving complex decision-making problems. However, the process remains time-consuming and error-prone, heavily relying on domain experts. While Large Language Models (LLMs) show promise in addressing these challenges through their natural language understanding and reasoning capabilities, current approaches face three critical limitations: high benchmark labeling error rates reaching up to 42%, narrow evaluation scope that only considers optimal values, and computational inefficiency due to heavy reliance on multi-agent systems or model fine-tuning. In this work, we first enhance existing datasets through systematic error correction and more comprehensive annotation. Additionally, we introduce LogiOR, a new optimization modeling benchmark from the logistics domain, containing more complex problems with standardized annotations. Furthermore, we present ORThought, a novel framework that leverages expert-level optimization modeling principles through chain-of-thought reasoning to automate the OM process. Through extensive empirical evaluation, we demonstrate that ORThought outperforms existing approaches, including multi-agent frameworks, with particularly significant advantages on complex optimization problems. Finally, we provide a systematic analysis of our method, identifying critical success factors and failure modes, providing valuable insights for future research on LLM-based optimization modeling.

Evaluating Cognitive Maps and Planning in Large Language Models with CogEval

Recently an influx of studies claim emergent cognitive abilities in large language models (LLMs). Yet, most rely on anecdotes, overlook contamination of training sets, or lack systematic Evaluation involving multiple tasks, control conditions, multiple iterations, and statistical robustness tests. Here we make two major contributions. First, we propose CogEval, a cognitive science-inspired protocol for the systematic evaluation of cognitive capacities in Large Language Models. The CogEval protocol can be followed for the evaluation of various abilities. Second, here we follow CogEval to systematically evaluate cognitive maps and planning ability across eight LLMs (OpenAI GPT-4, GPT-3.5-turbo-175B, davinci-003-175B, Google Bard, Cohere-xlarge-52.4B, Anthropic Claude-1-52B, LLaMA-13B, and Alpaca-7B). We base our task prompts on human experiments, which offer both established construct validity for evaluating planning, and are absent from LLM training sets. We find that, while LLMs show apparent competence in a few planning tasks with simpler structures, systematic evaluation reveals striking failure modes in planning tasks, including hallucinations of invalid trajectories and getting trapped in loops. These findings do not support the idea of emergent out-of-the-box planning ability in LLMs. This could be because LLMs do not understand the latent relational structures underlying planning problems, known as cognitive maps, and fail at unrolling goal-directed trajectories based on the underlying structure. Implications for application and future directions are discussed.

Beyond Benchmarks: Dynamic, Automatic And Systematic Red-Teaming Agents For Trustworthy Medical Language Models

Ensuring the safety and reliability of large language models (LLMs) in clinical practice is critical to prevent patient harm and promote trustworthy healthcare applications of AI. However, LLMs are advancing so rapidly that static safety benchmarks often become obsolete upon publication, yielding only an incomplete and sometimes misleading picture of model trustworthiness. We demonstrate that a Dynamic, Automatic, and Systematic (DAS) red-teaming framework that continuously stress-tests LLMs can reveal significant weaknesses of current LLMs across four safety-critical domains: robustness, privacy, bias/fairness, and hallucination. A suite of adversarial agents is applied to autonomously mutate test cases, identify/evolve unsafe-triggering strategies, and evaluate responses, uncovering vulnerabilities in real time without human intervention. Applying DAS to 15 proprietary and open-source LLMs revealed a stark contrast between static benchmark performance and vulnerability under adversarial pressure. Despite a median MedQA accuracy exceeding 80\%, 94\% of previously correct answers failed our dynamic robustness tests. We observed similarly high failure rates across other domains: privacy leaks were elicited in 86\% of scenarios, cognitive-bias priming altered clinical recommendations in 81\% of fairness tests, and we identified hallucination rates exceeding 66\% in widely used models. Such profound residual risks are incompatible with routine clinical practice. By converting red-teaming from a static checklist into a dynamic stress-test audit, DAS red-teaming offers the surveillance that hospitals/regulators/technology vendors require as LLMs become embedded in patient chatbots, decision-support dashboards, and broader healthcare workflows. Our framework delivers an evolvable, scalable, and reliable safeguard for the next generation of medical AI.

In Search of the Long-Tail: Systematic Generation of Long-Tail Knowledge via Logical Rule Guided Search

Since large language models have approached human-level performance on many tasks, it has become increasingly harder for researchers to find tasks that are still challenging to the models. Failure cases usually come from the long-tail distribution - data that an oracle language model could assign a probability on the lower end of its distribution. Current methodology such as prompt engineering or crowdsourcing are insufficient for creating long-tail examples because humans are constrained by cognitive bias. We propose a Logic-Induced-Knowledge-Search (LINK) framework for systematically generating long-tail knowledge statements. Grounded by a symbolic rule, we search for long-tail values for each variable of the rule by first prompting a LLM, then verifying the correctness of the values with a critic, and lastly pushing for the long-tail distribution with a reranker. With this framework we construct a dataset, Logic-Induced-Long-Tail (LINT), consisting of 200 symbolic rules and 50K knowledge statements spanning across four domains. Human annotations find that 84% of the statements in LINT are factually correct. In contrast, ChatGPT and GPT4 struggle with directly generating long-tail statements under the guidance of logic rules, each only getting 56% and 78% of their statements correct. Moreover, their "long-tail" generations in fact fall into the higher likelihood range, and thus are not really long-tail. Our findings suggest that LINK is effective for generating data in the long-tail distribution while enforcing quality. LINT can be useful for systematically evaluating LLMs' capabilities in the long-tail distribution. We challenge the models with a simple entailment classification task using samples from LINT. We find that ChatGPT and GPT4's capability in identifying incorrect knowledge drop by ~3% in the long-tail distribution compared to head distribution.

ValUES: A Framework for Systematic Validation of Uncertainty Estimation in Semantic Segmentation

Uncertainty estimation is an essential and heavily-studied component for the reliable application of semantic segmentation methods. While various studies exist claiming methodological advances on the one hand, and successful application on the other hand, the field is currently hampered by a gap between theory and practice leaving fundamental questions unanswered: Can data-related and model-related uncertainty really be separated in practice? Which components of an uncertainty method are essential for real-world performance? Which uncertainty method works well for which application? In this work, we link this research gap to a lack of systematic and comprehensive evaluation of uncertainty methods. Specifically, we identify three key pitfalls in current literature and present an evaluation framework that bridges the research gap by providing 1) a controlled environment for studying data ambiguities as well as distribution shifts, 2) systematic ablations of relevant method components, and 3) test-beds for the five predominant uncertainty applications: OoD-detection, active learning, failure detection, calibration, and ambiguity modeling. Empirical results on simulated as well as real-world data demonstrate how the proposed framework is able to answer the predominant questions in the field revealing for instance that 1) separation of uncertainty types works on simulated data but does not necessarily translate to real-world data, 2) aggregation of scores is a crucial but currently neglected component of uncertainty methods, 3) While ensembles are performing most robustly across the different downstream tasks and settings, test-time augmentation often constitutes a light-weight alternative. Code is at: https://github.com/IML-DKFZ/values

OmniEAR: Benchmarking Agent Reasoning in Embodied Tasks

Large language models excel at abstract reasoning but their capacity for embodied agent reasoning remains largely unexplored. We present OmniEAR, a comprehensive framework for evaluating how language models reason about physical interactions, tool usage, and multi-agent coordination in embodied tasks. Unlike existing benchmarks that provide predefined tool sets or explicit collaboration directives, OmniEAR requires agents to dynamically acquire capabilities and autonomously determine coordination strategies based on task demands. Through text-based environment representation, we model continuous physical properties and complex spatial relationships across 1,500 scenarios spanning household and industrial domains. Our systematic evaluation reveals severe performance degradation when models must reason from constraints: while achieving 85-96% success with explicit instructions, performance drops to 56-85% for tool reasoning and 63-85% for implicit collaboration, with compound tasks showing over 50% failure rates. Surprisingly, complete environmental information degrades coordination performance, indicating models cannot filter task-relevant constraints. Fine-tuning improves single-agent tasks dramatically (0.6% to 76.3%) but yields minimal multi-agent gains (1.5% to 5.5%), exposing fundamental architectural limitations. These findings demonstrate that embodied reasoning poses fundamentally different challenges than current models can address, establishing OmniEAR as a rigorous benchmark for evaluating and advancing embodied AI systems. Our code and data are included in the supplementary materials and will be open-sourced upon acceptance.

HumanEval Pro and MBPP Pro: Evaluating Large Language Models on Self-invoking Code Generation

We introduce self-invoking code generation, a new task designed to evaluate the progressive reasoning and problem-solving capabilities of LLMs. In this task, models are presented with a base problem and a related, more complex problem. They must solve the base problem and then utilize its solution to address the more complex one. This work features three key contributions. First, we propose a general recipe for generating more challenging versions of existing benchmarks, resulting in three new benchmarks: HumanEval Pro, MBPP Pro, and BigCodeBench-Lite Pro, specifically designed to assess LLMs on self-invoking code generation. Second, from the analysis of experimental results over twenty LLMs on our benchmarks, we have two important observations: (i) Most LLMs excel in traditional code generation benchmarks like HumanEval and MBPP, but their performance declines on self-invoking tasks. For example, o1-mini achieves 96.2% pass@1 on HumanEval but only 76.2% on HumanEval Pro. (ii) On self-invoking code generation task, the instruction-tuned models demonstrate only marginal improvements compared to the base models. Third, we disclose the types of failure modes that exist in our evaluation results. All these results underscore the need for further advancements in self-invoking code generation tasks and provide a new direction for future research on enhancing LLMs' code reasoning capabilities.

A Comprehensive Survey in LLM(-Agent) Full Stack Safety: Data, Training and Deployment

The remarkable success of Large Language Models (LLMs) has illuminated a promising pathway toward achieving Artificial General Intelligence for both academic and industrial communities, owing to their unprecedented performance across various applications. As LLMs continue to gain prominence in both research and commercial domains, their security and safety implications have become a growing concern, not only for researchers and corporations but also for every nation. Currently, existing surveys on LLM safety primarily focus on specific stages of the LLM lifecycle, e.g., deployment phase or fine-tuning phase, lacking a comprehensive understanding of the entire "lifechain" of LLMs. To address this gap, this paper introduces, for the first time, the concept of "full-stack" safety to systematically consider safety issues throughout the entire process of LLM training, deployment, and eventual commercialization. Compared to the off-the-shelf LLM safety surveys, our work demonstrates several distinctive advantages: (I) Comprehensive Perspective. We define the complete LLM lifecycle as encompassing data preparation, pre-training, post-training, deployment and final commercialization. To our knowledge, this represents the first safety survey to encompass the entire lifecycle of LLMs. (II) Extensive Literature Support. Our research is grounded in an exhaustive review of over 800+ papers, ensuring comprehensive coverage and systematic organization of security issues within a more holistic understanding. (III) Unique Insights. Through systematic literature analysis, we have developed reliable roadmaps and perspectives for each chapter. Our work identifies promising research directions, including safety in data generation, alignment techniques, model editing, and LLM-based agent systems. These insights provide valuable guidance for researchers pursuing future work in this field.