Daily Papers

Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.

Recent advancements in large language models (LLMs) have shown promise in medical applications such as disease diagnosis and treatment planning. However, most existing medical LLMs struggle with the advanced reasoning required for complex clinical scenarios, such as differential diagnosis or personalized treatment suggestions. We proposed FineMedLM-o1, which leverages high-quality synthetic medical data and long-form reasoning data for Supervised Fine-Tuning (SFT) and Direct Preference Optimization (DPO), enabling advanced dialogue and deep reasoning capabilities. Additionally, we introduced Test-Time Training (TTT) in the medical domain for the first time, facilitating domain adaptation and ensuring reliable, accurate reasoning. Experimental results demonstrate that FineMedLM-o1 achieves a 23% average performance improvement over prior models on key medical benchmarks. Furthermore, the introduction of TTT provides an additional 14% performance boost, highlighting its effectiveness in enhancing medical reasoning capabilities. To support this process, we also proposed a novel method for synthesizing medical dialogue. Compared to other open-source datasets, our dataset stands out as superior in both quality and complexity. The project and data will be released on GitHub.

Dynamic treatment regimes (DTRs) are personalized, adaptive, multi-stage treatment plans that adapt treatment decisions both to an individual's initial features and to intermediate outcomes and features at each subsequent stage, which are affected by decisions in prior stages. Examples include personalized first- and second-line treatments of chronic conditions like diabetes, cancer, and depression, which adapt to patient response to first-line treatment, disease progression, and individual characteristics. While existing literature mostly focuses on estimating the optimal DTR from offline data such as from sequentially randomized trials, we study the problem of developing the optimal DTR in an online manner, where the interaction with each individual affect both our cumulative reward and our data collection for future learning. We term this the DTR bandit problem. We propose a novel algorithm that, by carefully balancing exploration and exploitation, is guaranteed to achieve rate-optimal regret when the transition and reward models are linear. We demonstrate our algorithm and its benefits both in synthetic experiments and in a case study of adaptive treatment of major depressive disorder using real-world data.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

In the pharmaceutical industry, the use of artificial intelligence (AI) has seen consistent growth over the past decade. This rise is attributed to major advancements in statistical machine learning methodologies, computational capabilities and the increased availability of large datasets. AI techniques are applied throughout different stages of drug development, ranging from drug discovery to post-marketing benefit-risk assessment. Kolluri et al. provided a review of several case studies that span these stages, featuring key applications such as protein structure prediction, success probability estimation, subgroup identification, and AI-assisted clinical trial monitoring. From a regulatory standpoint, there was a notable uptick in submissions incorporating AI components in 2021. The most prevalent therapeutic areas leveraging AI were oncology (27%), psychiatry (15%), gastroenterology (12%), and neurology (11%). The paradigm of personalized or precision medicine has gained significant traction in recent research, partly due to advancements in AI techniques hamburg2010path. This shift has had a transformative impact on the pharmaceutical industry. Departing from the traditional "one-size-fits-all" model, personalized medicine incorporates various individual factors, such as environmental conditions, lifestyle choices, and health histories, to formulate customized treatment plans. By utilizing sophisticated machine learning algorithms, clinicians and researchers are better equipped to make informed decisions in areas such as disease prevention, diagnosis, and treatment selection, thereby optimizing health outcomes for each individual.

The objective of personalized medicine is to tailor interventions to an individual patient's unique characteristics. A key technology for this purpose involves medical digital twins, computational models of human biology that can be personalized and dynamically updated to incorporate patient-specific data collected over time. Certain aspects of human biology, such as the immune system, are not easily captured with physics-based models, such as differential equations. Instead, they are often multi-scale, stochastic, and hybrid. This poses a challenge to existing model-based control and optimization approaches that cannot be readily applied to such models. Recent advances in automatic differentiation and neural-network control methods hold promise in addressing complex control problems. However, the application of these approaches to biomedical systems is still in its early stages. This work introduces dynamics-informed neural-network controllers as an alternative approach to control of medical digital twins. As a first use case for this method, the focus is on agent-based models, a versatile and increasingly common modeling platform in biomedicine. The effectiveness of the proposed neural-network control method is illustrated and benchmarked against other methods with two widely-used agent-based model types. The relevance of the method introduced here extends beyond medical digital twins to other complex dynamical systems.

To effectively optimize and personalize treatments, it is necessary to investigate the heterogeneity of treatment effects. With the wide range of users being treated over many online controlled experiments, the typical approach of manually investigating each dimension of heterogeneity becomes overly cumbersome and prone to subjective human biases. We need an efficient way to search through thousands of experiments with hundreds of target covariates and hundreds of breakdown dimensions. In this paper, we propose a systematic paradigm for detecting, surfacing and characterizing heterogeneous treatment effects. First, we detect if treatment effect variation is present in an experiment, prior to specifying any breakdowns. Second, we surface the most relevant dimensions for heterogeneity. Finally, we characterize the heterogeneity beyond just the conditional average treatment effects (CATE) by studying the conditional distributions of the estimated individual treatment effects. We show the effectiveness of our methods using simulated data and empirical studies.

Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.

Current mental-health conversational systems are usually based on fixed, generic dialogue patterns. This paper proposes an adaptive framework based on large language models that aims to personalize therapeutic interaction according to a user's psychological state, quantified with the Acceptance of Illness Scale (AIS). The framework defines three specialized agents, L, M, and H, each linked to a different level of illness acceptance, and adjusts conversational behavior over time using continuous feedback signals. The AIS-stratified architecture is treated as a diegetic prototype placed in a plausible near-future setting and examined through the method of design fiction. By embedding the architecture in narrative scenarios, the study explores how such agents might influence access to care and therapeutic relationship. The goal is to show how clinically informed personalization, technical feasibility, and speculative scenario analysis can together inform the responsible design of LLM-based companions for mental-health support.

Personalized treatment effect estimates are often of interest in high-stakes applications -- thus, before deploying a model estimating such effects in practice, one needs to be sure that the best candidate from the ever-growing machine learning toolbox for this task was chosen. Unfortunately, due to the absence of counterfactual information in practice, it is usually not possible to rely on standard validation metrics for doing so, leading to a well-known model selection dilemma in the treatment effect estimation literature. While some solutions have recently been investigated, systematic understanding of the strengths and weaknesses of different model selection criteria is still lacking. In this paper, instead of attempting to declare a global `winner', we therefore empirically investigate success- and failure modes of different selection criteria. We highlight that there is a complex interplay between selection strategies, candidate estimators and the data used for comparing them, and provide interesting insights into the relative (dis)advantages of different criteria alongside desiderata for the design of further illuminating empirical studies in this context.

Over the past decade, machine learning has revolutionized computers' ability to analyze text through flexible computational models. Due to their structural similarity to written language, transformer-based architectures have also shown promise as tools to make sense of a range of multi-variate sequences from protein-structures, music, electronic health records to weather-forecasts. We can also represent human lives in a way that shares this structural similarity to language. From one perspective, lives are simply sequences of events: People are born, visit the pediatrician, start school, move to a new location, get married, and so on. Here, we exploit this similarity to adapt innovations from natural language processing to examine the evolution and predictability of human lives based on detailed event sequences. We do this by drawing on arguably the most comprehensive registry data in existence, available for an entire nation of more than six million individuals across decades. Our data include information about life-events related to health, education, occupation, income, address, and working hours, recorded with day-to-day resolution. We create embeddings of life-events in a single vector space showing that this embedding space is robust and highly structured. Our models allow us to predict diverse outcomes ranging from early mortality to personality nuances, outperforming state-of-the-art models by a wide margin. Using methods for interpreting deep learning models, we probe the algorithm to understand the factors that enable our predictions. Our framework allows researchers to identify new potential mechanisms that impact life outcomes and associated possibilities for personalized interventions.

Current large language model (LLM) development treats task-solving and preference alignment as separate challenges, optimizing first for objective correctness, then for alignment to aggregated human preferences. This paradigm fails in human-facing applications where solving a problem correctly is insufficient if the response mismatches the user's needs. This challenge intensifies in just-in-time scenarios where no prior user interaction history exists due to cold-start conditions or privacy constraints. LLMs need to identify what they don't know about user preferences, strategically elicit preference values through questioning, then adapt their reasoning processes and responses accordingly -- a complicated chain of cognitive processes which we term personalized reasoning. We introduce PREFDISCO, an evaluation methodology that transforms static benchmarks into interactive personalization tasks using psychologically-grounded personas with sparse preferences. Our framework creates scenarios where identical questions require different reasoning chains depending on user context, as optimal explanation approaches vary by individual expertise and preferences while maintaining factual accuracy. Evaluation of 21 frontier models across 10 tasks reveals 29.0% of naive personalization attempts produce worse preference alignment than generic responses, yet generic responses also fail to serve individual user needs effectively. These findings suggest personalized reasoning requires dedicated development rather than emerging naturally. PREFDISCO establishes personalized reasoning as a measurable research frontier and reveals fundamental limitations in current LLMs' interactive capabilities, providing a foundation for developing systems that can adapt to individual users in education, healthcare, and technical domains where personalization is critical.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

Personalization of Large Language Models (LLMs) has recently become increasingly important with a wide range of applications. Despite the importance and recent progress, most existing works on personalized LLMs have focused either entirely on (a) personalized text generation or (b) leveraging LLMs for personalization-related downstream applications, such as recommendation systems. In this work, we bridge the gap between these two separate main directions for the first time by introducing a taxonomy for personalized LLM usage and summarizing the key differences and challenges. We provide a formalization of the foundations of personalized LLMs that consolidates and expands notions of personalization of LLMs, defining and discussing novel facets of personalization, usage, and desiderata of personalized LLMs. We then unify the literature across these diverse fields and usage scenarios by proposing systematic taxonomies for the granularity of personalization, personalization techniques, datasets, evaluation methods, and applications of personalized LLMs. Finally, we highlight challenges and important open problems that remain to be addressed. By unifying and surveying recent research using the proposed taxonomies, we aim to provide a clear guide to the existing literature and different facets of personalization in LLMs, empowering both researchers and practitioners.

The increased capabilities of generative AI have dramatically expanded its possible use cases in medicine. We provide a comprehensive overview of generative AI use cases for clinicians, patients, clinical trial organizers, researchers, and trainees. We then discuss the many challenges -- including maintaining privacy and security, improving transparency and interpretability, upholding equity, and rigorously evaluating models -- which must be overcome to realize this potential, and the open research directions they give rise to.

Clinical predictive models often rely on patients' electronic health records (EHR), but integrating medical knowledge to enhance predictions and decision-making is challenging. This is because personalized predictions require personalized knowledge graphs (KGs), which are difficult to generate from patient EHR data. To address this, we propose GraphCare, an open-world framework that uses external KGs to improve EHR-based predictions. Our method extracts knowledge from large language models (LLMs) and external biomedical KGs to build patient-specific KGs, which are then used to train our proposed Bi-attention AugmenTed (BAT) graph neural network (GNN) for healthcare predictions. On two public datasets, MIMIC-III and MIMIC-IV, GraphCare surpasses baselines in four vital healthcare prediction tasks: mortality, readmission, length of stay (LOS), and drug recommendation. On MIMIC-III, it boosts AUROC by 17.6\% and 6.6\% for mortality and readmission, and F1-score by 7.9\% and 10.8\% for LOS and drug recommendation, respectively. Notably, GraphCare demonstrates a substantial edge in scenarios with limited data availability. Our findings highlight the potential of using external KGs in healthcare prediction tasks and demonstrate the promise of GraphCare in generating personalized KGs for promoting personalized medicine.

Machine learning models are often personalized with information that is protected, sensitive, self-reported, or costly to acquire. These models use information about people but do not facilitate nor inform their consent. Individuals cannot opt out of reporting personal information to a model, nor tell if they benefit from personalization in the first place. We introduce a family of classification models, called participatory systems, that let individuals opt into personalization at prediction time. We present a model-agnostic algorithm to learn participatory systems for personalization with categorical group attributes. We conduct a comprehensive empirical study of participatory systems in clinical prediction tasks, benchmarking them with common approaches for personalization and imputation. Our results demonstrate that participatory systems can facilitate and inform consent while improving performance and data use across all groups who report personal data.

As mental health issues globally escalate, there is a tremendous need for advanced digital support systems. We introduce MentalAgora, a novel framework employing large language models enhanced by interaction between multiple agents for tailored mental health support. This framework operates through three stages: strategic debating, tailored counselor creation, and response generation, enabling the dynamic customization of responses based on individual user preferences and therapeutic needs. We conduct experiments utilizing a high-quality evaluation dataset TherapyTalk crafted with mental health professionals, shwoing that MentalAgora generates expert-aligned and user preference-enhanced responses. Our evaluations, including experiments and user studies, demonstrate that MentalAgora aligns with professional standards and effectively meets user preferences, setting a new benchmark for digital mental health interventions.

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.

Alzheimer's disease (AD) is a degenerative brain disease impairing a person's ability to perform day to day activities. The clinical manifestations of Alzheimer's disease are characterized by heterogeneity in age, disease span, progression rate, impairment of memory and cognitive abilities. Due to these variabilities, personalized care and treatment planning, as well as patient counseling about their individual progression is limited. Recent developments in machine learning to detect hidden patterns in complex, multi-dimensional datasets provides significant opportunities to address this critical need. In this work, we use unsupervised and supervised machine learning approaches for subtype identification and prediction. We apply machine learning methods to the extensive clinical observations available at the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set to identify patient subtypes and to predict disease progression. Our analysis depicts the progression space for the Alzheimer's disease into low, moderate and high disease progression zones. The proposed work will enable early detection and characterization of distinct disease subtypes based on clinical heterogeneity. We anticipate that our models will enable patient counseling, clinical trial design, and ultimately individualized clinical care.

Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.

Background: Electronic Health Records hold detailed longitudinal information about each patient's health status and general clinical history, a large portion of which is stored within the unstructured text. Existing approaches focus mostly on structured data and a subset of single-domain outcomes. We explore how temporal modelling of patients from free text and structured data, using deep generative transformers can be used to forecast a wide range of future disorders, substances, procedures or findings. Methods: We present Foresight, a novel transformer-based pipeline that uses named entity recognition and linking tools to convert document text into structured, coded concepts, followed by providing probabilistic forecasts for future medical events such as disorders, substances, procedures and findings. We processed the entire free-text portion from three different hospital datasets totalling 811336 patients covering both physical and mental health. Findings: On tests in two UK hospitals (King's College Hospital, South London and Maudsley) and the US MIMIC-III dataset precision@10 0.68, 0.76 and 0.88 was achieved for forecasting the next disorder in a patient timeline, while precision@10 of 0.80, 0.81 and 0.91 was achieved for forecasting the next biomedical concept. Foresight was also validated on 34 synthetic patient timelines by five clinicians and achieved relevancy of 97% for the top forecasted candidate disorder. As a generative model, it can forecast follow-on biomedical concepts for as many steps as required. Interpretation: Foresight is a general-purpose model for biomedical concept modelling that can be used for real-world risk forecasting, virtual trials and clinical research to study the progression of disorders, simulate interventions and counterfactuals, and educational purposes.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Combination therapies have become the standard of care for diseases such as cancer, tuberculosis, malaria and HIV. However, the combinatorial set of available multi-drug treatments creates a challenge in identifying effective combination therapies available in a situation. To assist medical professionals in identifying beneficial drug-combinations, we construct an expert-annotated dataset for extracting information about the efficacy of drug combinations from the scientific literature. Beyond its practical utility, the dataset also presents a unique NLP challenge, as the first relation extraction dataset consisting of variable-length relations. Furthermore, the relations in this dataset predominantly require language understanding beyond the sentence level, adding to the challenge of this task. We provide a promising baseline model and identify clear areas for further improvement. We release our dataset, code, and baseline models publicly to encourage the NLP community to participate in this task.

We present a novel approach to personalized sleep health management using few-shot Chain-of-Thought (CoT) distillation, enabling small-scale language models (> 2B parameters) to rival the performance of large language models (LLMs) in specialized health domains. Our method simultaneously distills problem-solving strategies, long-tail expert knowledge, and personalized recommendation capabilities from larger models into more efficient, compact models. Unlike existing systems, our approach offers three key functionalities: generating personalized sleep health recommendations, supporting user-specific follow-up inquiries, and providing responses to domain-specific knowledge questions. We focus on sleep health due to its measurability via wearable devices and its impact on overall well-being. Our experimental setup, involving GPT-4o for data synthesis, Qwen-max for instruction set creation, and Qwen2.5 1.5B for model distillation, demonstrates significant improvements over baseline small-scale models in penalization, reasoning, and knowledge application. Experiments using 100 simulated sleep reports and 1,000 domain-specific questions shows our model achieves comparable performance to larger models while maintaining efficiency for real-world deployment. This research not only advances AI-driven health management but also provides a novel approach to leveraging LLM capabilities in resource-constrained environments, potentially enhancing the accessibility of personalized healthcare solutions.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

Diabetes is a chronic disease that poses a significant global health burden, and optimizing diabetes management requires multi-stakeholder collaboration. Large language models (LLMs) have shown promise in various healthcare scenarios, but their effectiveness across a diverse range of diabetes tasks remains unproven. In this study, we introduced a framework to train and validate diabetes-specific LLMs. We first developed a comprehensive data processing pipeline that includes data collection, filtering, augmentation and refinement. This approach contributes to creating a high-quality, diabetes-specific dataset, and several evaluation benchmarks entirely from scratch. Utilizing the collected training dataset, we fine-tuned a diabetes-specific LLM family that demonstrated state-of-the-art proficiency in understanding and processing various diabetes tasks compared to other LLMs. Furthermore, clinical studies showed the potential applications of our models in diabetes care, including providing personalized healthcare, assisting medical education, and streamlining clinical tasks. In conclusion, our study introduced a framework to develop and evaluate a diabetes-specific LLM family, and highlighted its potential to enhance clinical practice and provide personalized, data-driven support for diabetes support when facing different end users. The code is provided via GitHub at https://github.com/waltonfuture/Diabetica.

Large language models (LLMs) have emerged as powerful tools for analyzing complex datasets. Recent studies demonstrate their potential to generate useful, personalized responses when provided with patient-specific health information that encompasses lifestyle, biomarkers, and context. As LLM-driven health applications are increasingly adopted, rigorous and efficient one-sided evaluation methodologies are crucial to ensure response quality across multiple dimensions, including accuracy, personalization and safety. Current evaluation practices for open-ended text responses heavily rely on human experts. This approach introduces human factors and is often cost-prohibitive, labor-intensive, and hinders scalability, especially in complex domains like healthcare where response assessment necessitates domain expertise and considers multifaceted patient data. In this work, we introduce Adaptive Precise Boolean rubrics: an evaluation framework that streamlines human and automated evaluation of open-ended questions by identifying gaps in model responses using a minimal set of targeted rubrics questions. Our approach is based on recent work in more general evaluation settings that contrasts a smaller set of complex evaluation targets with a larger set of more precise, granular targets answerable with simple boolean responses. We validate this approach in metabolic health, a domain encompassing diabetes, cardiovascular disease, and obesity. Our results demonstrate that Adaptive Precise Boolean rubrics yield higher inter-rater agreement among expert and non-expert human evaluators, and in automated assessments, compared to traditional Likert scales, while requiring approximately half the evaluation time of Likert-based methods. This enhanced efficiency, particularly in automated evaluation and non-expert contributions, paves the way for more extensive and cost-effective evaluation of LLMs in health.

Personalization, the ability to tailor a system to individual users, is an essential factor in user experience with natural language processing (NLP) systems. With the emergence of Large Language Models (LLMs), a key question is how to leverage these models to better personalize user experiences. To personalize a language model's output, a straightforward approach is to incorporate past user data into the language model prompt, but this approach can result in lengthy inputs exceeding limitations on input length and incurring latency and cost issues. Existing approaches tackle such challenges by selectively extracting relevant user data (i.e. selective retrieval) to construct a prompt for downstream tasks. However, retrieval-based methods are limited by potential information loss, lack of more profound user understanding, and cold-start challenges. To overcome these limitations, we propose a novel summary-augmented approach by extending retrieval-augmented personalization with task-aware user summaries generated by LLMs. The summaries can be generated and stored offline, enabling real-world systems with runtime constraints like voice assistants to leverage the power of LLMs. Experiments show our method with 75% less of retrieved user data is on-par or outperforms retrieval augmentation on most tasks in the LaMP personalization benchmark. We demonstrate that offline summarization via LLMs and runtime retrieval enables better performance for personalization on a range of tasks under practical constraints.

Recent text-to-image diffusion models are able to learn and synthesize images containing novel, personalized concepts (e.g., their own pets or specific items) with just a few examples for training. This paper tackles two interconnected issues within this realm of personalizing text-to-image diffusion models. First, current personalization techniques fail to reliably extend to multiple concepts -- we hypothesize this to be due to the mismatch between complex scenes and simple text descriptions in the pre-training dataset (e.g., LAION). Second, given an image containing multiple personalized concepts, there lacks a holistic metric that evaluates performance on not just the degree of resemblance of personalized concepts, but also whether all concepts are present in the image and whether the image accurately reflects the overall text description. To address these issues, we introduce Gen4Gen, a semi-automated dataset creation pipeline utilizing generative models to combine personalized concepts into complex compositions along with text-descriptions. Using this, we create a dataset called MyCanvas, that can be used to benchmark the task of multi-concept personalization. In addition, we design a comprehensive metric comprising two scores (CP-CLIP and TI-CLIP) for better quantifying the performance of multi-concept, personalized text-to-image diffusion methods. We provide a simple baseline built on top of Custom Diffusion with empirical prompting strategies for future researchers to evaluate on MyCanvas. We show that by improving data quality and prompting strategies, we can significantly increase multi-concept personalized image generation quality, without requiring any modifications to model architecture or training algorithms.

In this work, we introduce the task of life-long personalization of large language models. While recent mainstream efforts in the LLM community mainly focus on scaling data and compute for improved capabilities of LLMs, we argue that it is also very important to enable LLM systems, or language agents, to continuously adapt to the diverse and ever-changing profiles of every distinct user and provide up-to-date personalized assistance. We provide a clear task formulation and introduce a simple, general, effective, and scalable framework for life-long personalization of LLM systems and language agents. To facilitate future research on LLM personalization, we also introduce methods to synthesize realistic benchmarks and robust evaluation metrics. We will release all codes and data for building and benchmarking life-long personalized LLM systems.

Recent advancements in generative models have significantly facilitated the development of personalized content creation. Given a small set of images with user-specific concept, personalized image generation allows to create images that incorporate the specified concept and adhere to provided text descriptions. Due to its wide applications in content creation, significant effort has been devoted to this field in recent years. Nonetheless, the technologies used for personalization have evolved alongside the development of generative models, with their distinct and interrelated components. In this survey, we present a comprehensive review of generalized personalized image generation across various generative models, including traditional GANs, contemporary text-to-image diffusion models, and emerging multi-model autoregressive models. We first define a unified framework that standardizes the personalization process across different generative models, encompassing three key components, i.e., inversion spaces, inversion methods, and personalization schemes. This unified framework offers a structured approach to dissecting and comparing personalization techniques across different generative architectures. Building upon this unified framework, we further provide an in-depth analysis of personalization techniques within each generative model, highlighting their unique contributions and innovations. Through comparative analysis, this survey elucidates the current landscape of personalized image generation, identifying commonalities and distinguishing features among existing methods. Finally, we discuss the open challenges in the field and propose potential directions for future research. We keep tracing related works at https://github.com/csyxwei/Awesome-Personalized-Image-Generation.

As large language models (LLMs) evolve, their ability to deliver personalized and context-aware responses offers transformative potential for improving user experiences. Existing personalization approaches, however, often rely solely on user history to augment the prompt, limiting their effectiveness in generating tailored outputs, especially in cold-start scenarios with sparse data. To address these limitations, we propose Personalized Graph-based Retrieval-Augmented Generation (PGraphRAG), a framework that leverages user-centric knowledge graphs to enrich personalization. By directly integrating structured user knowledge into the retrieval process and augmenting prompts with user-relevant context, PGraphRAG enhances contextual understanding and output quality. We also introduce the Personalized Graph-based Benchmark for Text Generation, designed to evaluate personalized text generation tasks in real-world settings where user history is sparse or unavailable. Experimental results show that PGraphRAG significantly outperforms state-of-the-art personalization methods across diverse tasks, demonstrating the unique advantages of graph-based retrieval for personalization.

Machine learning models are often personalized with categorical attributes that are protected, sensitive, self-reported, or costly to acquire. In this work, we show models that are personalized with group attributes can reduce performance at a group level. We propose formal conditions to ensure the "fair use" of group attributes in prediction tasks by training one additional model -- i.e., collective preference guarantees to ensure that each group who provides personal data will receive a tailored gain in performance in return. We present sufficient conditions to ensure fair use in empirical risk minimization and characterize failure modes that lead to fair use violations due to standard practices in model development and deployment. We present a comprehensive empirical study of fair use in clinical prediction tasks. Our results demonstrate the prevalence of fair use violations in practice and illustrate simple interventions to mitigate their harm.

Content creators often aim to create personalized images using personal subjects that go beyond the capabilities of conventional text-to-image models. Additionally, they may want the resulting image to encompass a specific location, style, ambiance, and more. Existing personalization methods may compromise personalization ability or the alignment to complex textual prompts. This trade-off can impede the fulfillment of user prompts and subject fidelity. We propose a new approach focusing on personalization methods for a single prompt to address this issue. We term our approach prompt-aligned personalization. While this may seem restrictive, our method excels in improving text alignment, enabling the creation of images with complex and intricate prompts, which may pose a challenge for current techniques. In particular, our method keeps the personalized model aligned with a target prompt using an additional score distillation sampling term. We demonstrate the versatility of our method in multi- and single-shot settings and further show that it can compose multiple subjects or use inspiration from reference images, such as artworks. We compare our approach quantitatively and qualitatively with existing baselines and state-of-the-art techniques.

Personalized interaction is highly valued by parents in their story-reading activities with children. While AI-empowered story-reading tools have been increasingly used, their abilities to support personalized interaction with children are still limited. Recent advances in large language models (LLMs) show promise in facilitating personalized interactions, but little is known about how to effectively and appropriately use LLMs to enhance children's personalized story-reading experiences. This work explores this question through a design-based study. Drawing on a formative study, we designed and developed StoryMate, an LLM-empowered personalized interactive story-reading tool for children, following an empirical study with children, parents, and education experts. Our participants valued the personalized features in StoryMate, and also highlighted the need to support personalized content, guiding mechanisms, reading context variations, and interactive interfaces. Based on these findings, we propose a series of design recommendations for better using LLMs to empower children's personalized story reading and interaction.

Effective conversational agents must be able to personalize their behavior to suit a user's preferences, personality, and attributes, whether they are assisting with writing tasks or operating in domains like education or healthcare. Current training methods like Reinforcement Learning from Human Feedback (RLHF) prioritize helpfulness and safety but fall short in fostering truly empathetic, adaptive, and personalized interactions. Traditional approaches to personalization often rely on extensive user history, limiting their effectiveness for new or context-limited users. To overcome these limitations, we propose to incorporate an intrinsic motivation to improve the conversational agents's model of the user as an additional reward alongside multi-turn RLHF. This reward mechanism encourages the agent to actively elicit user traits by optimizing conversations to increase the accuracy of its user model. Consequently, the policy agent can deliver more personalized interactions through obtaining more information about the user. We applied our method both education and fitness settings, where LLMs teach concepts or recommend personalized strategies based on users' hidden learning style or lifestyle attributes. Using LLM-simulated users, our approach outperformed a multi-turn RLHF baseline in revealing information about the users' preferences, and adapting to them.

Large language models demonstrate impressive reasoning abilities but struggle to provide personalized content due to their lack of individual user preference information. Existing methods, such as in-context learning and parameter-efficient fine-tuning, fall short in capturing the complexity of human preferences, especially given the small, personal datasets individuals possess. In this paper, we propose a novel approach utilizing small parameter models as preference agents to generate natural language rules that guide a larger, pre-trained model, enabling efficient personalization. Our method involves a small, local "steering wheel" model that directs the outputs of a much larger foundation model, producing content tailored to an individual's preferences while leveraging the extensive knowledge and capabilities of the large model. Importantly, this personalization is achieved without the need to fine-tune the large model. Experimental results on email and article datasets, demonstrate that our technique significantly outperforms baseline personalization methods. By allowing foundation models to adapt to individual preferences in a data and compute-efficient manner, our approach paves the way for highly personalized language model applications.

Recent advancements in machine learning and natural language processing have led to the rapid development of artificial intelligence (AI) as a valuable tool in the healthcare industry. Using large language models (LLMs) as conversational agents or chatbots has the potential to assist doctors in diagnosing patients, detecting early symptoms of diseases, and providing health advice to patients. This paper focuses on the role of chatbots in healthcare and explores the use of avatars to make AI interactions more appealing to patients. A framework of a general-purpose AI avatar application is demonstrated by using a three-category prompt dictionary and prompt improvement mechanism. A two-phase approach is suggested to fine-tune a general-purpose AI language model and create different AI avatars to discuss medical issues with users. Prompt engineering enhances the chatbot's conversational abilities and personality traits, fostering a more human-like interaction with patients. Ultimately, the injection of personality into the chatbot could potentially increase patient engagement. Future directions for research include investigating ways to improve chatbots' understanding of context and ensuring the accuracy of their outputs through fine-tuning with specialized medical data sets.

Numerous biological and physical processes can be modeled as systems of interacting entities evolving continuously over time, e.g. the dynamics of communicating cells or physical particles. Learning the dynamics of such systems is essential for predicting the temporal evolution of populations across novel samples and unseen environments. Flow-based models allow for learning these dynamics at the population level - they model the evolution of the entire distribution of samples. However, current flow-based models are limited to a single initial population and a set of predefined conditions which describe different dynamics. We argue that multiple processes in natural sciences have to be represented as vector fields on the Wasserstein manifold of probability densities. That is, the change of the population at any moment in time depends on the population itself due to the interactions between samples. In particular, this is crucial for personalized medicine where the development of diseases and their respective treatment response depends on the microenvironment of cells specific to each patient. We propose Meta Flow Matching (MFM), a practical approach to integrating along these vector fields on the Wasserstein manifold by amortizing the flow model over the initial populations. Namely, we embed the population of samples using a Graph Neural Network (GNN) and use these embeddings to train a Flow Matching model. This gives MFM the ability to generalize over the initial distributions unlike previously proposed methods. We demonstrate the ability of MFM to improve prediction of individual treatment responses on a large scale multi-patient single-cell drug screen dataset.

Diffusion models have demonstrated impressive image generation capabilities. Personalized approaches, such as textual inversion and Dreambooth, enhance model individualization using specific images. These methods enable generating images of specific objects based on diverse textual contexts. Our proposed approach aims to retain the model's original knowledge during new information integration, resulting in superior outcomes while necessitating less training time compared to Dreambooth and textual inversion.

With the rapid development of large language models in recent years, there has been an increasing demand for domain-specific Agents that can cater to the unique needs of enterprises and organizations. Unlike general models, which strive for broad coverage, these specialized Agents rely on focused datasets tailored to their intended applications. This research proposes a pipeline that leverages the power of LLMs and the Retrieval-Augmented Generation related framework to construct high-quality instruction datasets for fine-tuning on specific domains using custom document collections. By ingesting domain-specific documents, the pipeline generates relevant and contextually appropriate instructions, thus effectively creating a comprehensive dataset for fine-tuning LLMs on the target domain. This approach overcomes the limitations of traditional dataset creation methods, which often rely on manual curation or web-scraping techniques that may introduce noise and irrelevant data. Notably, our pipeline offers a dynamic solution that can quickly adapt to updates or modifications in the domain-specific document collection, eliminating the need for complete retraining. Additionally, it addresses the challenge of data scarcity by enabling the generation of instruction datasets from a limited set of initial documents, rendering it suitable for unpopular or specialized domains where comprehensive datasets are scarce. As a case study, we apply this approach to the domain of psychiatry, a field requiring specialized knowledge and sensitive handling of patient information. The resulting fine-tuned LLM demonstrates showcases the viability of the proposed approach and underscores its potential for widespread adoption across various industries and domains where tailored, accurate, and contextually relevant language models are indispensable.

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

Clinical trial matching is a key process in health delivery and discovery. In practice, it is plagued by overwhelming unstructured data and unscalable manual processing. In this paper, we conduct a systematic study on scaling clinical trial matching using large language models (LLMs), with oncology as the focus area. Our study is grounded in a clinical trial matching system currently in test deployment at a large U.S. health network. Initial findings are promising: out of box, cutting-edge LLMs, such as GPT-4, can already structure elaborate eligibility criteria of clinical trials and extract complex matching logic (e.g., nested AND/OR/NOT). While still far from perfect, LLMs substantially outperform prior strong baselines and may serve as a preliminary solution to help triage patient-trial candidates with humans in the loop. Our study also reveals a few significant growth areas for applying LLMs to end-to-end clinical trial matching, such as context limitation and accuracy, especially in structuring patient information from longitudinal medical records.

Large Language Models (LLMs) show promise in biomedicine but lack true causal understanding, relying instead on correlations. This paper envisions causal LLM agents that integrate multimodal data (text, images, genomics, etc.) and perform intervention-based reasoning to infer cause-and-effect. Addressing this requires overcoming key challenges: designing safe, controllable agentic frameworks; developing rigorous benchmarks for causal evaluation; integrating heterogeneous data sources; and synergistically combining LLMs with structured knowledge (KGs) and formal causal inference tools. Such agents could unlock transformative opportunities, including accelerating drug discovery through automated hypothesis generation and simulation, enabling personalized medicine through patient-specific causal models. This research agenda aims to foster interdisciplinary efforts, bridging causal concepts and foundation models to develop reliable AI partners for biomedical progress.

Personalized generation models for a single subject have demonstrated remarkable effectiveness, highlighting their significant potential. However, when extended to multiple subjects, existing models often exhibit degraded performance, particularly in maintaining subject consistency and adhering to textual prompts. We attribute these limitations to the absence of high-quality multi-subject datasets and refined post-training strategies. To address these challenges, we propose a scalable multi-subject data generation pipeline that leverages powerful single-subject generation models to construct diverse and high-quality multi-subject training data. Through this dataset, we first enable single-subject personalization models to acquire knowledge of synthesizing multi-image and multi-subject scenarios. Furthermore, to enhance both subject consistency and text controllability, we design a set of Pairwise Subject-Consistency Rewards and general-purpose rewards, which are incorporated into a refined reinforcement learning stage. To comprehensively evaluate multi-subject personalization, we introduce a new benchmark that assesses model performance using seven subsets across three dimensions. Extensive experiments demonstrate the effectiveness of our approach in advancing multi-subject personalized image generation. Github Link: https://github.com/wang-shulei/PSR

Personalization is critical in AI assistants, particularly in the context of private AI models that work with individual users. A key scenario in this domain involves enabling AI models to access and interpret a user's private data (e.g., conversation history, user-AI interactions, app usage) to understand personal details such as biographical information, preferences, and social connections. However, due to the sensitive nature of such data, there are no publicly available datasets that allow us to assess an AI model's ability to understand users through direct access to personal information. To address this gap, we introduce a synthetic data generation pipeline that creates diverse, realistic user profiles and private documents simulating human activities. Leveraging this synthetic data, we present PersonaBench, a benchmark designed to evaluate AI models' performance in understanding personal information derived from simulated private user data. We evaluate Retrieval-Augmented Generation (RAG) pipelines using questions directly related to a user's personal information, supported by the relevant private documents provided to the models. Our results reveal that current retrieval-augmented AI models struggle to answer private questions by extracting personal information from user documents, highlighting the need for improved methodologies to enhance personalization capabilities in AI.

Decision-makers are often experts of their domain and take actions based on their domain knowledge. Doctors, for instance, may prescribe treatments by predicting the likely outcome of each available treatment. Actions of an expert thus naturally encode part of their domain knowledge, and can help make inferences within the same domain: Knowing doctors try to prescribe the best treatment for their patients, we can tell treatments prescribed more frequently are likely to be more effective. Yet in machine learning, the fact that most decision-makers are experts is often overlooked, and "expertise" is seldom leveraged as an inductive bias. This is especially true for the literature on treatment effect estimation, where often the only assumption made about actions is that of overlap. In this paper, we argue that expertise - particularly the type of expertise the decision-makers of a domain are likely to have - can be informative in designing and selecting methods for treatment effect estimation. We formally define two types of expertise, predictive and prognostic, and demonstrate empirically that: (i) the prominent type of expertise in a domain significantly influences the performance of different methods in treatment effect estimation, and (ii) it is possible to predict the type of expertise present in a dataset, which can provide a quantitative basis for model selection.

We introduce Radiology-GPT, a large language model for radiology. Using an instruction tuning approach on an extensive dataset of radiology domain knowledge, Radiology-GPT demonstrates superior performance compared to general language models such as StableLM, Dolly and LLaMA. It exhibits significant versatility in radiological diagnosis, research, and communication. This work serves as a catalyst for future developments in clinical NLP. The successful implementation of Radiology-GPT is indicative of the potential of localizing generative large language models, specifically tailored for distinctive medical specialties, while ensuring adherence to privacy standards such as HIPAA. The prospect of developing individualized, large-scale language models that cater to specific needs of various hospitals presents a promising direction. The fusion of conversational competence and domain-specific knowledge in these models is set to foster future development in healthcare AI. A demo of Radiology-GPT is available at https://huggingface.co/spaces/allen-eric/radiology-gpt.

Aligning with personalized preferences, which vary significantly across cultural, educational, and political differences, poses a significant challenge due to the computational costs and data demands of traditional alignment methods. In response, this paper presents Personalized Alignment at Decoding-time (PAD), a novel framework designed to align LLM outputs with diverse personalized preferences during the inference phase, eliminating the need for additional training. By introducing a unique personalized reward modeling strategy, this framework decouples the text generation process from personalized preferences, facilitating the generation of generalizable token-level personalized rewards. The PAD algorithm leverages these rewards to guide the decoding process, dynamically tailoring the base model's predictions to personalized preferences. Extensive experimental results demonstrate that PAD not only outperforms existing training-based alignment methods in terms of aligning with diverse preferences but also shows significant generalizability to preferences unseen during training and scalability across different base models. This work advances the capability of LLMs to meet user needs in real-time applications, presenting a substantial step forward in personalized LLM alignment.

Visual personalization is essential in user-facing AI systems such as smart homes and healthcare, where aligning model behavior with user-centric concepts is critical. However, recent large Vision-Language Models (VLMs), despite their broad applicability, remain underexplored in their ability to adapt to individual users. In this paper, we introduce MMPB, the first extensive benchmark for evaluating VLMs on personalization. MMPB comprises 10k image-query pairs and includes 111 personalizable concepts across four categories: humans, animals, objects, and characters, with the human category enriched with preference-grounded queries. We structure personalization into three main task types, each highlighting a different key property of VLMs. Using 23 widely used VLMs including both open- and closed-source models, we evaluate personalization performance via a three-stage protocol: concept injection, multi-turn dialogue, and personalized querying. Our findings indicate that most VLMs (including some closed-source models) struggle with personalization, particularly in maintaining consistency over dialogue, handling user preferences, and adapting to visual cues. Our analysis reveals that the challenges in VLM personalization (such as refusal behaviors and long-context forgetting) highlight substantial room for improvement. By identifying these limitations and offering a scalable benchmark, MMPB offers valuable insights and a solid foundation for future research toward truly personalized multi-modal AI. Project Page: aidaslab.github.io/MMPB

Estimating the impact of continuous treatment variables (e.g., dosage amount) on binary outcomes presents significant challenges in modeling and estimation because many existing approaches make strong assumptions that do not hold for certain continuous treatment variables. For instance, traditional logistic regression makes strong linearity assumptions that do not hold for continuous treatment variables like time of initiation. In this work, we propose a semiparametric regression framework that decomposes effects into two interpretable components: a prognostic score that captures baseline outcome risk based on a combination of clinical, genetic, and sociodemographic features, and a treatment-interaction score that flexibly models the optimal treatment level via a nonparametric link function. By connecting these two parametric scores with Nadaraya-Watson regression, our approach is both interpretable and flexible. The potential of our approach is demonstrated through numerical simulations that show empirical estimation convergence. We conclude by applying our approach to a real-world case study using the International Warfarin Pharmacogenomics Consortium (IWPC) dataset to show our approach's clinical utility by deriving personalized warfarin dosing recommendations that integrate both genetic and clinical data, providing insights towards enhancing patient safety and therapeutic efficacy in anticoagulation therapy.

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

Clinical trial matching is the task of identifying trials for which patients may be potentially eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process is manual, time-intensive, and challenging to scale up, resulting in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.

VR simulation in Health Professions (HP) education demonstrates huge potential, but fixed learning content with little customization limits its application beyond lab environments. To address these limitations in the context of VR for patient communication training, we conducted a user-centered study involving semi-structured interviews with advanced HP students to understand their challenges in clinical communication training and perceptions of VR-based solutions. From this, we derived design insights emphasizing the importance of realistic scenarios, simple interactions, and unpredictable dialogues. Building on these insights, we developed the Virtual AI Patient Simulator (VAPS), a novel VR system powered by Large Language Models (LLMs) and Embodied Conversational Agents (ECAs), supporting dynamic and customizable patient interactions for immersive learning. We also provided an example of how clinical professors could use user-friendly design forms to create personalized scenarios that align with course objectives in VAPS and discuss future implications of integrating AI-driven technologies into VR education.

Disease progression simulation is a crucial area of research that has significant implications for clinical diagnosis, prognosis, and treatment. One major challenge in this field is the lack of continuous medical imaging monitoring of individual patients over time. To address this issue, we develop a novel framework termed Progressive Image Editing (PIE) that enables controlled manipulation of disease-related image features, facilitating precise and realistic disease progression simulation. Specifically, we leverage recent advancements in text-to-image generative models to simulate disease progression accurately and personalize it for each patient. We theoretically analyze the iterative refining process in our framework as a gradient descent with an exponentially decayed learning rate. To validate our framework, we conduct experiments in three medical imaging domains. Our results demonstrate the superiority of PIE over existing methods such as Stable Diffusion Walk and Style-Based Manifold Extrapolation based on CLIP score (Realism) and Disease Classification Confidence (Alignment). Our user study collected feedback from 35 veteran physicians to assess the generated progressions. Remarkably, 76.2% of the feedback agrees with the fidelity of the generated progressions. To our best knowledge, PIE is the first of its kind to generate disease progression images meeting real-world standards. It is a promising tool for medical research and clinical practice, potentially allowing healthcare providers to model disease trajectories over time, predict future treatment responses, and improve patient outcomes.

In domains with high stakes such as law, recruitment, and healthcare, learning models frequently rely on sensitive user data for inference, necessitating the complete set of features. This not only poses significant privacy risks for individuals but also demands substantial human effort from organizations to verify information accuracy. This paper asks whether it is necessary to use all input features for accurate predictions at inference time. The paper demonstrates that, in a personalized setting, individuals may only need to disclose a small subset of their features without compromising decision-making accuracy. The paper also provides an efficient sequential algorithm to determine the appropriate attributes for each individual to provide. Evaluations across various learning tasks show that individuals can potentially report as little as 10\% of their information while maintaining the same accuracy level as a model that employs the full set of user information.

Personalization plays a critical role in numerous language tasks and applications, since users with the same requirements may prefer diverse outputs based on their individual interests. This has led to the development of various personalized approaches aimed at adapting large language models (LLMs) to generate customized outputs aligned with user preferences. Some of them involve fine-tuning a unique personalized LLM for each user, which is too expensive for widespread application. Alternative approaches introduce personalization information in a plug-and-play manner by retrieving the user's relevant historical texts as demonstrations. However, this retrieval-based strategy may break the continuity of the user history and fail to capture the user's overall styles and patterns, hence leading to sub-optimal performance. To address these challenges, we propose a novel personalized LLM model, . It constructs a user-specific embedding for each individual by modeling all her historical contexts through a lightweight plug-in user embedder module. By attaching this embedding to the task input, LLMs can better understand and capture user habits and preferences, thereby producing more personalized outputs without tuning their own parameters. Extensive experiments on various tasks in the language model personalization (LaMP) benchmark demonstrate that the proposed model significantly outperforms existing personalized LLM approaches.

Survival analysis, or time-to-event modelling, is a classical statistical problem that has garnered a lot of interest for its practical use in epidemiology, demographics or actuarial sciences. Recent advances on the subject from the point of view of machine learning have been concerned with precise per-individual predictions instead of population studies, driven by the rise of individualized medicine. We introduce here a conditional normalizing flow based estimate of the time-to-event density as a way to model highly flexible and individualized conditional survival distributions. We use a novel hierarchical formulation of normalizing flows to enable efficient fitting of flexible conditional distributions without overfitting and show how the normalizing flow formulation can be efficiently adapted to the censored setting. We experimentally validate the proposed approach on a synthetic dataset as well as four open medical datasets and an example of a common financial problem.

Recent researches of large language models(LLM), which is pre-trained on massive general-purpose corpora, have achieved breakthroughs in responding human queries. However, these methods face challenges including limited data insufficiency to support extensive pre-training and can not align responses with users' instructions. To address these issues, we introduce a medical instruction dataset, CMedINS, containing six medical instructions derived from actual medical tasks, which effectively fine-tunes LLM in conjunction with other data. Subsequently, We launch our medical model, IIMedGPT, employing an efficient preference alignment method, Direct preference Optimization(DPO). The results show that our final model outperforms existing medical models in medical dialogue.Datsets, Code and model checkpoints will be released upon acceptance.

Personalized financial advice requires consideration of user goals, constraints, risk tolerance, and jurisdiction. Prior LLM work has focused on support systems for investors and financial planners. Simultaneously, numerous recent studies examine broader personal finance tasks, including budgeting, debt management, retirement, and estate planning, through agentic pipelines that incur high maintenance costs, yielding less than 25% of their expected financial returns. In this study, we introduce a novel and reproducible framework that integrates relevant financial context with behavioral finance studies to construct supervision data for end-to-end advisors. Using this framework, we create a 19k sample reasoning dataset and conduct a comprehensive fine-tuning of the Qwen-3-8B model on the dataset. Through a held-out test split and a blind LLM-jury study, we demonstrate that through careful data curation and behavioral integration, our 8B model achieves performance comparable to significantly larger baselines (14-32B parameters) across factual accuracy, fluency, and personalization metrics while incurring 80% lower costs than the larger counterparts.

Personalized text generation is an emerging research area that has attracted much attention in recent years. Most studies in this direction focus on a particular domain by designing bespoke features or models. In this work, we propose a general approach for personalized text generation using large language models (LLMs). Inspired by the practice of writing education, we develop a multistage and multitask framework to teach LLMs for personalized generation. In writing instruction, the task of writing from sources is often decomposed into multiple steps that involve finding, evaluating, summarizing, synthesizing, and integrating information. Analogously, our approach to personalized text generation consists of multiple stages: retrieval, ranking, summarization, synthesis, and generation. In addition, we introduce a multitask setting that helps the model improve its generation ability further, which is inspired by the observation in education that a student's reading proficiency and writing ability are often correlated. We evaluate our approach on three public datasets, each of which covers a different and representative domain. Our results show significant improvements over a variety of baselines.

Clinical trials are fundamental in developing new drugs, medical devices, and treatments. However, they are often time-consuming and have low success rates. Although there have been initial attempts to create large language models (LLMs) for clinical trial design and patient-trial matching, these models remain task-specific and not adaptable to diverse clinical trial tasks. To address this challenge, we propose a clinical trial foundation model named Panacea, designed to handle multiple tasks, including trial search, trial summarization, trial design, and patient-trial matching. We also assemble a large-scale dataset, named TrialAlign, of 793,279 trial documents and 1,113,207 trial-related scientific papers, to infuse clinical knowledge into the model by pre-training. We further curate TrialInstruct, which has 200,866 of instruction data for fine-tuning. These resources enable Panacea to be widely applicable for a range of clinical trial tasks based on user requirements. We evaluated Panacea on a new benchmark, named TrialPanorama, which covers eight clinical trial tasks. Our method performed the best on seven of the eight tasks compared to six cutting-edge generic or medicine-specific LLMs. Specifically, Panacea showed great potential to collaborate with human experts in crafting the design of eligibility criteria, study arms, and outcome measures, in multi-round conversations. In addition, Panacea achieved 14.42% improvement in patient-trial matching, 41.78% to 52.02% improvement in trial search, and consistently ranked at the top for five aspects of trial summarization. Our approach demonstrates the effectiveness of Panacea in clinical trials and establishes a comprehensive resource, including training data, model, and benchmark, for developing clinical trial foundation models, paving the path for AI-based clinical trial development.

With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Since the COVID-19 pandemic, clinicians have seen a large and sustained influx in patient portal messages, significantly contributing to clinician burnout. To the best of our knowledge, there are no large-scale public patient portal messages corpora researchers can use to build tools to optimize clinician portal workflows. Informed by our ongoing work with a regional hospital, this study introduces an LLM-powered framework for configurable and realistic patient portal message generation. Our approach leverages few-shot grounded text generation, requiring only a small number of de-identified patient portal messages to help LLMs better match the true style and tone of real data. Clinical experts in our team deem this framework as HIPAA-friendly, unlike existing privacy-preserving approaches to synthetic text generation which cannot guarantee all sensitive attributes will be protected. Through extensive quantitative and human evaluation, we show that our framework produces data of higher quality than comparable generation methods as well as all related datasets. We believe this work provides a path forward for (i) the release of large-scale synthetic patient message datasets that are stylistically similar to ground-truth samples and (ii) HIPAA-friendly data generation which requires minimal human de-identification efforts.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

The recommendation of medication is a vital aspect of intelligent healthcare systems, as it involves prescribing the most suitable drugs based on a patient's specific health needs. Unfortunately, many sophisticated models currently in use tend to overlook the nuanced semantics of medical data, while only relying heavily on identities. Furthermore, these models face significant challenges in handling cases involving patients who are visiting the hospital for the first time, as they lack prior prescription histories to draw upon. To tackle these issues, we harness the powerful semantic comprehension and input-agnostic characteristics of Large Language Models (LLMs). Our research aims to transform existing medication recommendation methodologies using LLMs. In this paper, we introduce a novel approach called Large Language Model Distilling Medication Recommendation (LEADER). We begin by creating appropriate prompt templates that enable LLMs to suggest medications effectively. However, the straightforward integration of LLMs into recommender systems leads to an out-of-corpus issue specific to drugs. We handle it by adapting the LLMs with a novel output layer and a refined tuning loss function. Although LLM-based models exhibit remarkable capabilities, they are plagued by high computational costs during inference, which is impractical for the healthcare sector. To mitigate this, we have developed a feature-level knowledge distillation technique, which transfers the LLM's proficiency to a more compact model. Extensive experiments conducted on two real-world datasets, MIMIC-III and MIMIC-IV, demonstrate that our proposed model not only delivers effective results but also is efficient. To ease the reproducibility of our experiments, we release the implementation code online.

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluated eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3, was validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare.

Large language models (LLMs) have significantly advanced Natural Language Processing (NLP) tasks in recent years. However, their universal nature poses limitations in scenarios requiring personalized responses, such as recommendation systems and chatbots. This paper investigates methods to personalize LLMs, comparing fine-tuning and zero-shot reasoning approaches on subjective tasks. Results demonstrate that personalized fine-tuning improves model reasoning compared to non-personalized models. Experiments on datasets for emotion recognition and hate speech detection show consistent performance gains with personalized methods across different LLM architectures. These findings underscore the importance of personalization for enhancing LLM capabilities in subjective text perception tasks.

Recent large language models (LLMs) in the general domain, such as ChatGPT, have shown remarkable success in following instructions and producing human-like responses. However, such language models have not been learned individually and carefully for the medical domain, resulting in poor diagnostic accuracy and inability to give correct recommendations for medical diagnosis, medications, etc. To address this issue, we collected more than 700 diseases and their corresponding symptoms, recommended medications, and required medical tests, and then generated 5K doctor-patient conversations. By fine-tuning models of doctor-patient conversations, these models emerge with great potential to understand patients' needs, provide informed advice, and offer valuable assistance in a variety of medical-related fields. The integration of these advanced language models into healthcare can revolutionize the way healthcare professionals and patients communicate, ultimately improving the overall quality of care and patient outcomes. In addition, we will open all source code, datasets and model weights to advance the further development of dialogue models in the medical field. In addition, the training data, code, and weights of this project are available at: https://github.com/Kent0n-Li/ChatDoctor.

Machine learning (ML) recourse techniques are increasingly used in high-stakes domains, providing end users with actions to alter ML predictions, but they assume ML developers understand what input variables can be changed. However, a recourse plan's actionability is subjective and unlikely to match developers' expectations completely. We present GAM Coach, a novel open-source system that adapts integer linear programming to generate customizable counterfactual explanations for Generalized Additive Models (GAMs), and leverages interactive visualizations to enable end users to iteratively generate recourse plans meeting their needs. A quantitative user study with 41 participants shows our tool is usable and useful, and users prefer personalized recourse plans over generic plans. Through a log analysis, we explore how users discover satisfactory recourse plans, and provide empirical evidence that transparency can lead to more opportunities for everyday users to discover counterintuitive patterns in ML models. GAM Coach is available at: https://poloclub.github.io/gam-coach/.

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

Survival risk stratification is an important step in clinical decision making for breast cancer management. We propose a novel deep learning approach for this purpose by integrating histopathological imaging, genetic and clinical data. It employs vision transformers, specifically the MaxViT model, for image feature extraction, and self-attention to capture intricate image relationships at the patient level. A dual cross-attention mechanism fuses these features with genetic data, while clinical data is incorporated at the final layer to enhance predictive accuracy. Experiments on the public TCGA-BRCA dataset show that our model, trained using the negative log likelihood loss function, can achieve superior performance with a mean C-index of 0.64, surpassing existing methods. This advancement facilitates tailored treatment strategies, potentially leading to improved patient outcomes.

Large Language Models (LLMs) and multi-agent systems have shown impressive capabilities in natural language tasks but face challenges in clinical trial applications, primarily due to limited access to external knowledge. Recognizing the potential of advanced clinical trial tools that aggregate and predict based on the latest medical data, we propose an integrated solution to enhance their accessibility and utility. We introduce Clinical Agent System (ClinicalAgent), a clinical multi-agent system designed for clinical trial tasks, leveraging GPT-4, multi-agent architectures, LEAST-TO-MOST, and ReAct reasoning technology. This integration not only boosts LLM performance in clinical contexts but also introduces novel functionalities. The proposed method achieves competitive predictive performance in clinical trial outcome prediction (0.7908 PR-AUC), obtaining a 0.3326 improvement over the standard prompt Method. Publicly available code can be found at https://anonymous.4open.science/r/ClinicalAgent-6671.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Implicit Personalization (IP) is a phenomenon of language models inferring a user's background from the implicit cues in the input prompts and tailoring the response based on this inference. While previous work has touched upon various instances of this problem, there lacks a unified framework to study this behavior. This work systematically studies IP through a rigorous mathematical formulation, a multi-perspective moral reasoning framework, and a set of case studies. Our theoretical foundation for IP relies on a structural causal model and introduces a novel method, indirect intervention, to estimate the causal effect of a mediator variable that cannot be directly intervened upon. Beyond the technical approach, we also introduce a set of moral reasoning principles based on three schools of moral philosophy to study when IP may or may not be ethically appropriate. Equipped with both mathematical and ethical insights, we present three diverse case studies illustrating the varied nature of the IP problem and offer recommendations for future research. Our code and data are at https://github.com/jiarui-liu/IP.

The development and popularization of large language models (LLMs) have raised concerns that they will be used to create tailor-made, convincing arguments to push false or misleading narratives online. Early work has found that language models can generate content perceived as at least on par and often more persuasive than human-written messages. However, there is still limited knowledge about LLMs' persuasive capabilities in direct conversations with human counterparts and how personalization can improve their performance. In this pre-registered study, we analyze the effect of AI-driven persuasion in a controlled, harmless setting. We create a web-based platform where participants engage in short, multiple-round debates with a live opponent. Each participant is randomly assigned to one of four treatment conditions, corresponding to a two-by-two factorial design: (1) Games are either played between two humans or between a human and an LLM; (2) Personalization might or might not be enabled, granting one of the two players access to basic sociodemographic information about their opponent. We found that participants who debated GPT-4 with access to their personal information had 81.7% (p < 0.01; N=820 unique participants) higher odds of increased agreement with their opponents compared to participants who debated humans. Without personalization, GPT-4 still outperforms humans, but the effect is lower and statistically non-significant (p=0.31). Overall, our results suggest that concerns around personalization are meaningful and have important implications for the governance of social media and the design of new online environments.

Deep Research Agents (DRAs) can autonomously conduct complex investigations and generate comprehensive reports, demonstrating strong real-world potential. However, existing evaluations mostly rely on close-ended benchmarks, while open-ended deep research benchmarks remain scarce and typically neglect personalized scenarios. To bridge this gap, we introduce Personalized Deep Research Bench, the first benchmark for evaluating personalization in DRAs. It pairs 50 diverse research tasks across 10 domains with 25 authentic user profiles that combine structured persona attributes with dynamic real-world contexts, yielding 250 realistic user-task queries. To assess system performance, we propose the PQR Evaluation Framework, which jointly measures (P) Personalization Alignment, (Q) Content Quality, and (R) Factual Reliability. Our experiments on a range of systems highlight current capabilities and limitations in handling personalized deep research. This work establishes a rigorous foundation for developing and evaluating the next generation of truly personalized AI research assistants.

Personalizing large language models (LLMs) for individual users has become increasingly important as they are progressively integrated into real-world applications to support users' daily lives. However, existing personalization approaches often fail to distinguish which components of model predictions and training data truly reflect user preferences, leading to superficial personalization alignment. In this paper, we introduce NextQuill, a novel LLM personalization alignment framework grounded in causal preference modeling. We approach personalization from a causal perspective, treating both model predictions and ground-truth data generation as outcomes influenced by user preferences, along with other factors. We define the true preference effect as the causal impact of user history (which reflects preferences) on each token prediction or data generation instance, estimated through causal intervention techniques. Building on this insight, NextQuill introduces two complementary alignment strategies: (1) aligning model-internal causal preference effects on predictions with those reflected in ground-truth data, rather than indiscriminately fitting predictions, and (2) focusing on fitting preference-bearing tokens identified via ground-truth data preference effects, rather than treating all tokens uniformly. By integrating these strategies, NextQuill shifts the alignment process toward learning from causal preference effects, facilitating more effective and personalized adaptation. Experiments across multiple personalization benchmarks demonstrate that NextQuill significantly improves personalization quality, offering a principled, causal foundation for LLM personalization. Our codes are available on https://github.com/juntaoyou/NextQuill.

The proliferation of Large Language Models (LLMs) in medicine has enabled impressive capabilities, yet a critical gap remains in their ability to perform systematic, transparent, and verifiable reasoning, a cornerstone of clinical practice. This has catalyzed a shift from single-step answer generation to the development of LLMs explicitly designed for medical reasoning. This paper provides the first systematic review of this emerging field. We propose a taxonomy of reasoning enhancement techniques, categorized into training-time strategies (e.g., supervised fine-tuning, reinforcement learning) and test-time mechanisms (e.g., prompt engineering, multi-agent systems). We analyze how these techniques are applied across different data modalities (text, image, code) and in key clinical applications such as diagnosis, education, and treatment planning. Furthermore, we survey the evolution of evaluation benchmarks from simple accuracy metrics to sophisticated assessments of reasoning quality and visual interpretability. Based on an analysis of 60 seminal studies from 2022-2025, we conclude by identifying critical challenges, including the faithfulness-plausibility gap and the need for native multimodal reasoning, and outlining future directions toward building efficient, robust, and sociotechnically responsible medical AI.

Personalizing Large Language Models (LLMs) has become a critical step in facilitating their widespread application to enhance individual life experiences. In pursuit of personalization, distilling key preference information from an individual's historical data as instructional preference context to customize LLM generation has emerged as a promising direction. However, these methods face a fundamental limitation by overlooking the inter-user comparative analysis, which is essential for identifying the inter-user differences that truly shape preferences. To address this limitation, we propose Difference-aware Personalization Learning (DPL), a novel approach that emphasizes extracting inter-user differences to enhance LLM personalization. DPL strategically selects representative users for comparison and establishes a structured standard to extract meaningful, task-relevant differences for customizing LLM generation. Extensive experiments on real-world datasets demonstrate that DPL significantly enhances LLM personalization. We release our code at https://github.com/SnowCharmQ/DPL.

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.

In modern commercial systems, including Recommendation, Ranking, and E-Commerce platforms, there is a trend towards improving customer experiences by incorporating Personalization context as input into Large Language Models (LLMs). However, LLMs often struggle to effectively parse and utilize sparse and complex personal context without additional processing or contextual enrichment, underscoring the need for more sophisticated context understanding mechanisms. In this work, we propose Guided Profile Generation (GPG), a general method designed to generate personal profiles in natural language. As is observed, intermediate guided profile generation enables LLMs to summarize, and extract the important, distinctive features from the personal context into concise, descriptive sentences, precisely tailoring their generation more closely to an individual's unique habits and preferences. Our experimental results show that GPG improves LLM's personalization ability across different tasks, for example, it increases 37% accuracy in predicting personal preference compared to directly feeding the LLMs with raw personal context.

Treatment effect estimation in continuous time is crucial for personalized medicine. However, existing methods for this task are limited to point estimates of the potential outcomes, whereas uncertainty estimates have been ignored. Needless to say, uncertainty quantification is crucial for reliable decision-making in medical applications. To fill this gap, we propose a novel Bayesian neural controlled differential equation (BNCDE) for treatment effect estimation in continuous time. In our BNCDE, the time dimension is modeled through a coupled system of neural controlled differential equations and neural stochastic differential equations, where the neural stochastic differential equations allow for tractable variational Bayesian inference. Thereby, for an assigned sequence of treatments, our BNCDE provides meaningful posterior predictive distributions of the potential outcomes. To the best of our knowledge, ours is the first tailored neural method to provide uncertainty estimates of treatment effects in continuous time. As such, our method is of direct practical value for promoting reliable decision-making in medicine.

Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client's actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client's motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

Most text-to-image customization techniques fine-tune models on a small set of personal concept images captured in minimal contexts. This often results in the model becoming overfitted to these training images and unable to generalize to new contexts in future text prompts. Existing customization methods are built on the success of effectively representing personal concepts as textual embeddings. Thus, in this work, we resort to diversifying the context of these personal concepts solely within the textual space by simply creating a contextually rich set of text prompts, together with a widely used self-supervised learning objective. Surprisingly, this straightforward and cost-effective method significantly improves semantic alignment in the textual space, and this effect further extends to the image space, resulting in higher prompt fidelity for generated images. Additionally, our approach does not require any architectural modifications, making it highly compatible with existing text-to-image customization methods. We demonstrate the broad applicability of our approach by combining it with four different baseline methods, achieving notable CLIP score improvements.

Digital twin technology has is anticipated to transform healthcare, enabling personalized medicines and support, earlier diagnoses, simulated treatment outcomes, and optimized surgical plans. Digital twins are readily gaining traction in industries like manufacturing, supply chain logistics, and civil infrastructure. Not in patient care, however. The challenge of modeling complex diseases with multimodal patient data and the computational complexities of analyzing it have stifled digital twin adoption in the biomedical vertical. Yet, these major obstacles can potentially be handled by approaching these models in a different way. This paper proposes a novel framework for addressing the barriers to clinical twin modeling created by computational costs and modeling complexities. We propose structuring patient health data as a knowledge graph and using closed-form continuous-time liquid neural networks, for real-time analytics. By synthesizing multimodal patient data and leveraging the flexibility and efficiency of closed form continuous time networks and knowledge graph ontologies, our approach enables real time insights, personalized medicine, early diagnosis and intervention, and optimal surgical planning. This novel approach provides a comprehensive and adaptable view of patient health along with real-time analytics, paving the way for digital twin simulations and other anticipated benefits in healthcare.

The recent emergence of Large Language Models (LLMs) has heralded a new era of human-AI interaction. These sophisticated models, exemplified by Chat-GPT and its successors, have exhibited remarkable capabilities in language understanding. However, as these LLMs have undergone exponential growth, a crucial dimension that remains understudied is the personalization of these models. Large foundation models such as GPT-3 etc. focus on creating a universal model that serves a broad range of tasks and users. This approach emphasizes the model's generalization capabilities, treating users as a collective rather than as distinct individuals. While practical for many common applications, this one-size-fits-all approach often fails to address the rich tapestry of human diversity and individual needs. To explore this issue we introduce the PEFT-U Benchmark: a new dataset for building and evaluating NLP models for user personalization. consists of a series of user-centered tasks containing diverse and individualized expressions where the preferences of users can potentially differ for the same input. Using PEFT-U, we explore the challenge of efficiently personalizing LLMs to accommodate user-specific preferences in the context of diverse user-centered tasks.

Large Language Models (LLMs) have demonstrated remarkable capabilities, yet their transition to real-world applications reveals a critical limitation: the inability to adapt to individual preferences while maintaining alignment with universal human values. Current alignment techniques adopt a one-size-fits-all approach that fails to accommodate users' diverse backgrounds and needs. This paper presents the first comprehensive survey of personalized alignment-a paradigm that enables LLMs to adapt their behavior within ethical boundaries based on individual preferences. We propose a unified framework comprising preference memory management, personalized generation, and feedback-based alignment, systematically analyzing implementation approaches and evaluating their effectiveness across various scenarios. By examining current techniques, potential risks, and future challenges, this survey provides a structured foundation for developing more adaptable and ethically-aligned LLMs.

Preference alignment has become a standard pipeline in finetuning models to follow generic human preferences. Majority of work seeks to optimize model to produce responses that would be preferable on average, simplifying the diverse and often contradicting space of human preferences. While research has increasingly focused on personalized alignment: adapting models to individual user preferences, there is a lack of personalized preference dataset which focus on nuanced individual-level preferences. To address this, we introduce WikiPersona: the first fine-grained personalization using well-documented, famous individuals. Our dataset challenges models to align with these personas through an interpretable process: generating verifiable textual descriptions of a persona's background and preferences in addition to alignment. We systematically evaluate different personalization approaches and find that as few-shot prompting with preferences and fine-tuning fail to simultaneously ensure effectiveness and efficiency, using inferred personal preferences as prefixes enables effective personalization, especially in topics where preferences clash while leading to more equitable generalization across unseen personas.

Large language models (LLMs) have recently achieved impressive performance across a wide range of natural language tasks and are now widely used in real-world applications. Among them, black-box LLMs--served via APIs without access to model internals--are especially dominant due to their scalability and ease of deployment. Despite their strong capabilities, these models typically produce generalized responses that overlook personal preferences and reasoning styles. This has led to growing interest in black-box LLM personalization, which aims to tailor model outputs to user-specific context without modifying model parameters. However, existing approaches primarily focus on response-level personalization, attempting to match final outputs without modeling personal thought process. To address this limitation, we propose RPM, a framework for reasoning-level personalization that aligns the model's reasoning process with a user's personalized logic. RPM first constructs statistical user-specific factors by extracting and grouping response-influential features from user history. It then builds personalized reasoning paths that reflect how these factors are used in context. In the inference stage, RPM retrieves reasoning-aligned examples for new queries via feature-level similarity and performs inference conditioned on the structured factors and retrieved reasoning paths, enabling the model to follow user-specific reasoning trajectories. This reasoning-level personalization enhances both predictive accuracy and interpretability by grounding model outputs in user-specific logic through structured information. Extensive experiments across diverse tasks show that RPM consistently outperforms response-level personalization methods, demonstrating the effectiveness of reasoning-level personalization in black-box LLMs.

Personalized image generation aims to integrate user-provided concepts into text-to-image models, enabling the generation of customized content based on a given prompt. Recent zero-shot approaches, particularly those leveraging diffusion transformers, incorporate reference image information through multi-modal attention mechanism. This integration allows the generated output to be influenced by both the textual prior from the prompt and the visual prior from the reference image. However, we observe that when the prompt and reference image are misaligned, the generated results exhibit a stronger bias toward the textual prior, leading to a significant loss of reference content. To address this issue, we propose AlignGen, a Cross-Modality Prior Alignment mechanism that enhances personalized image generation by: 1) introducing a learnable token to bridge the gap between the textual and visual priors, 2) incorporating a robust training strategy to ensure proper prior alignment, and 3) employing a selective cross-modal attention mask within the multi-modal attention mechanism to further align the priors. Experimental results demonstrate that AlignGen outperforms existing zero-shot methods and even surpasses popular test-time optimization approaches.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

Keeping track of scientific challenges, advances and emerging directions is a fundamental part of research. However, researchers face a flood of papers that hinders discovery of important knowledge. In biomedicine, this directly impacts human lives. To address this problem, we present a novel task of extraction and search of scientific challenges and directions, to facilitate rapid knowledge discovery. We construct and release an expert-annotated corpus of texts sampled from full-length papers, labeled with novel semantic categories that generalize across many types of challenges and directions. We focus on a large corpus of interdisciplinary work relating to the COVID-19 pandemic, ranging from biomedicine to areas such as AI and economics. We apply a model trained on our data to identify challenges and directions across the corpus and build a dedicated search engine. In experiments with 19 researchers and clinicians using our system, we outperform a popular scientific search engine in assisting knowledge discovery. Finally, we show that models trained on our resource generalize to the wider biomedical domain and to AI papers, highlighting its broad utility. We make our data, model and search engine publicly available. https://challenges.apps.allenai.org/

Personalized generation in T2I diffusion models aims to naturally incorporate individual user preferences into the generation process with minimal user intervention. However, existing studies primarily rely on prompt-level modeling with large-scale models, often leading to inaccurate personalization due to the limited input token capacity of T2I diffusion models. To address these limitations, we propose DrUM, a novel method that integrates user profiling with a transformer-based adapter to enable personalized generation through condition-level modeling in the latent space. DrUM demonstrates strong performance on large-scale datasets and seamlessly integrates with open-source text encoders, making it compatible with widely used foundation T2I models without requiring additional fine-tuning.

Machine learning (ML) holds great potential for accurately forecasting treatment outcomes over time, which could ultimately enable the adoption of more individualized treatment strategies in many practical applications. However, a significant challenge that has been largely overlooked by the ML literature on this topic is the presence of informative sampling in observational data. When instances are observed irregularly over time, sampling times are typically not random, but rather informative -- depending on the instance's characteristics, past outcomes, and administered treatments. In this work, we formalize informative sampling as a covariate shift problem and show that it can prohibit accurate estimation of treatment outcomes if not properly accounted for. To overcome this challenge, we present a general framework for learning treatment outcomes in the presence of informative sampling using inverse intensity-weighting, and propose a novel method, TESAR-CDE, that instantiates this framework using Neural CDEs. Using a simulation environment based on a clinical use case, we demonstrate the effectiveness of our approach in learning under informative sampling.

The way people respond to messaging from public health organizations on social media can provide insight into public perceptions on critical health issues, especially during a global crisis such as COVID-19. It could be valuable for high-impact organizations such as the US Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) to understand how these perceptions impact reception of messaging on health policy recommendations. We collect two datasets of public health messages and their responses from Twitter relating to COVID-19 and Vaccines, and introduce a predictive method which can be used to explore the potential reception of such messages. Specifically, we harness a generative model (GPT-2) to directly predict probable future responses and demonstrate how it can be used to optimize expected reception of important health guidance. Finally, we introduce a novel evaluation scheme with extensive statistical testing which allows us to conclude that our models capture the semantics and sentiment found in actual public health responses.

In this study, we aimed to determine if fine-tuned large language models (LLMs) can generate accurate, personalized impressions for whole-body PET reports. Twelve language models were trained on a corpus of PET reports using the teacher-forcing algorithm, with the report findings as input and the clinical impressions as reference. An extra input token encodes the reading physician's identity, allowing models to learn physician-specific reporting styles. Our corpus comprised 37,370 retrospective PET reports collected from our institution between 2010 and 2022. To identify the best LLM, 30 evaluation metrics were benchmarked against quality scores from two nuclear medicine (NM) physicians, with the most aligned metrics selecting the model for expert evaluation. In a subset of data, model-generated impressions and original clinical impressions were assessed by three NM physicians according to 6 quality dimensions (3-point scale) and an overall utility score (5-point scale). Each physician reviewed 12 of their own reports and 12 reports from other physicians. Bootstrap resampling was used for statistical analysis. Of all evaluation metrics, domain-adapted BARTScore and PEGASUSScore showed the highest Spearman's rank correlations (0.568 and 0.563) with physician preferences. Based on these metrics, the fine-tuned PEGASUS model was selected as the top LLM. When physicians reviewed PEGASUS-generated impressions in their own style, 89% were considered clinically acceptable, with a mean utility score of 4.08 out of 5. Physicians rated these personalized impressions as comparable in overall utility to the impressions dictated by other physicians (4.03, P=0.41). In conclusion, personalized impressions generated by PEGASUS were clinically useful, highlighting its potential to expedite PET reporting.

Abbreviation expansion is a strategy used to speed up communication by limiting the amount of typing and using a language model to suggest expansions. Here we look at personalizing a Large Language Model's (LLM) suggestions based on prior conversations to enhance the relevance of predictions, particularly when the user data is small (~1000 samples). Specifically, we compare fine-tuning, prompt-tuning, and retrieval augmented generation of expanded text suggestions for abbreviated inputs. Our case study with a deployed 8B parameter LLM on a real user living with ALS, and experiments on movie character personalization indicates that (1) customization may be necessary in some scenarios and prompt-tuning generalizes well to those, (2) fine-tuning on in-domain data (with as few as 600 samples) still shows some gains, however (3) retrieval augmented few-shot selection also outperforms fine-tuning. (4) Parameter efficient tuning allows for efficient and scalable personalization. For prompt-tuning, we also find that initializing the learned "soft-prompts" to user relevant concept tokens leads to higher accuracy than random initialization.

In recent years, there have been significant breakthroughs in the field of natural language processing, particularly with the development of large language models (LLMs). These LLMs have showcased remarkable capabilities on various benchmarks. In the healthcare field, the exact role LLMs and other future AI models will play remains unclear. There is a potential for these models in the future to be used as part of adaptive physician training, medical co-pilot applications, and digital patient interaction scenarios. The ability of AI models to participate in medical training and patient care will depend in part on their mastery of the knowledge content of specific medical fields. This study investigated the medical knowledge capability of LLMs, specifically in the context of internal medicine subspecialty multiple-choice test-taking ability. We compared the performance of several open-source LLMs (Koala 7B, Falcon 7B, Stable-Vicuna 13B, and Orca Mini 13B), to GPT-4 and Claude 2 on multiple-choice questions in the field of Nephrology. Nephrology was chosen as an example of a particularly conceptually complex subspecialty field within internal medicine. The study was conducted to evaluate the ability of LLM models to provide correct answers to nephSAP (Nephrology Self-Assessment Program) multiple-choice questions. The overall success of open-sourced LLMs in answering the 858 nephSAP multiple-choice questions correctly was 17.1% - 25.5%. In contrast, Claude 2 answered 54.4% of the questions correctly, whereas GPT-4 achieved a score of 73.3%. We show that current widely used open-sourced LLMs do poorly in their ability for zero-shot reasoning when compared to GPT-4 and Claude 2. The findings of this study potentially have significant implications for the future of subspecialty medical training and patient care.

Large language models (LLMs) have advanced conversational AI assistants. However, systematically evaluating how well these assistants apply personalization--adapting to individual user preferences while completing tasks--remains challenging. Existing personalization benchmarks focus on chit-chat, non-conversational tasks, or narrow domains, failing to capture the complexities of personalized task-oriented assistance. To address this, we introduce PersonaLens, a comprehensive benchmark for evaluating personalization in task-oriented AI assistants. Our benchmark features diverse user profiles equipped with rich preferences and interaction histories, along with two specialized LLM-based agents: a user agent that engages in realistic task-oriented dialogues with AI assistants, and a judge agent that employs the LLM-as-a-Judge paradigm to assess personalization, response quality, and task success. Through extensive experiments with current LLM assistants across diverse tasks, we reveal significant variability in their personalization capabilities, providing crucial insights for advancing conversational AI systems.

Recruiting patients to participate in clinical trials can be challenging and time-consuming. Usually, participation in a clinical trial is initiated by a healthcare professional and proposed to the patient. Promoting clinical trials directly to patients via online recruitment might help to reach them more efficiently. In this study, we address the case where a patient is initiating their own recruitment process and wants to determine whether they are eligible for a given clinical trial, using their own language to describe their medical profile. To study whether this creates difficulties in the patient trial matching process, we design a new dataset and task, Natural Language Inference for Patient Recruitment (NLI4PR), in which patient language profiles must be matched to clinical trials. We create it by adapting the TREC 2022 Clinical Trial Track dataset, which provides patients' medical profiles, and rephrasing them manually using patient language. We also use the associated clinical trial reports where the patients are either eligible or excluded. We prompt several open-source Large Language Models on our task and achieve from 56.5 to 71.8 of F1 score using patient language, against 64.7 to 73.1 for the same task using medical language. When using patient language, we observe only a small loss in performance for the best model, suggesting that having the patient as a starting point could be adopted to help recruit patients for clinical trials. The corpus and code bases are all freely available on our Github and HuggingFace repositories.

We study the problem of adaptively identifying patient subpopulations that benefit from a given treatment during a confirmatory clinical trial. This type of adaptive clinical trial has been thoroughly studied in biostatistics, but has been allowed only limited adaptivity so far. Here, we aim to relax classical restrictions on such designs and investigate how to incorporate ideas from the recent machine learning literature on adaptive and online experimentation to make trials more flexible and efficient. We find that the unique characteristics of the subpopulation selection problem -- most importantly that (i) one is usually interested in finding subpopulations with any treatment benefit (and not necessarily the single subgroup with largest effect) given a limited budget and that (ii) effectiveness only has to be demonstrated across the subpopulation on average -- give rise to interesting challenges and new desiderata when designing algorithmic solutions. Building on these findings, we propose AdaGGI and AdaGCPI, two meta-algorithms for subpopulation construction. We empirically investigate their performance across a range of simulation scenarios and derive insights into their (dis)advantages across different settings.

Personalized content filtering, such as recommender systems, has become a critical infrastructure to alleviate information overload. However, these systems merely filter existing content and are constrained by its limited diversity, making it difficult to meet users' varied content needs. To address this limitation, personalized content generation has emerged as a promising direction with broad applications. Nevertheless, most existing research focuses on personalized text generation, with relatively little attention given to personalized image generation. The limited work in personalized image generation faces challenges in accurately capturing users' visual preferences and needs from noisy user-interacted images and complex multimodal instructions. Worse still, there is a lack of supervised data for training personalized image generation models. To overcome the challenges, we propose a Personalized Image Generation Framework named Pigeon, which adopts exceptional large multimodal models with three dedicated modules to capture users' visual preferences and needs from noisy user history and multimodal instructions. To alleviate the data scarcity, we introduce a two-stage preference alignment scheme, comprising masked preference reconstruction and pairwise preference alignment, to align Pigeon with the personalized image generation task. We apply Pigeon to personalized sticker and movie poster generation, where extensive quantitative results and human evaluation highlight its superiority over various generative baselines.

Brain tumor growth is unique to each glioma patient and extends beyond what is visible in imaging scans, infiltrating surrounding brain tissue. Understanding these hidden patient-specific progressions is essential for effective therapies. Current treatment plans for brain tumors, such as radiotherapy, typically involve delineating a uniform margin around the visible tumor on pre-treatment scans to target this invisible tumor growth. This "one size fits all" approach is derived from population studies and often fails to account for the nuances of individual patient conditions. We present the GliODIL framework, which infers the full spatial distribution of tumor cell concentration from available multi-modal imaging, leveraging a Fisher-Kolmogorov type physics model to describe tumor growth. This is achieved through the newly introduced method of Optimizing the Discrete Loss (ODIL), where both data and physics-based constraints are softly assimilated into the solution. Our test dataset comprises 152 glioblastoma patients with pre-treatment imaging and post-treatment follow-ups for tumor recurrence monitoring. By blending data-driven techniques with physics-based constraints, GliODIL enhances recurrence prediction in radiotherapy planning, challenging traditional uniform margins and strict adherence to the Fisher-Kolmogorov partial differential equation (PDE) model, which is adapted for complex cases.

The development of large language models (LLMs) has significantly enhanced the capabilities of multimodal LLMs (MLLMs) as general assistants. However, lack of user-specific knowledge still restricts their application in human's daily life. In this paper, we introduce the Retrieval Augmented Personalization (RAP) framework for MLLMs' personalization. Starting from a general MLLM, we turn it into a personalized assistant in three steps. (a) Remember: We design a key-value database to store user-related information, e.g., user's name, avatar and other attributes. (b) Retrieve: When the user initiates a conversation, RAP will retrieve relevant information from the database using a multimodal retriever. (c) Generate: The input query and retrieved concepts' information are fed into MLLMs to generate personalized, knowledge-augmented responses. Unlike previous methods, RAP allows real-time concept editing via updating the external database. To further improve generation quality and alignment with user-specific information, we design a pipeline for data collection and create a specialized dataset for personalized training of MLLMs. Based on the dataset, we train a series of MLLMs as personalized multimodal assistants. By pretraining on large-scale dataset, RAP-MLLMs can generalize to infinite visual concepts without additional finetuning. Our models demonstrate outstanding flexibility and generation quality across a variety of tasks, such as personalized image captioning, question answering and visual recognition. The code, data and models are available at https://github.com/Hoar012/RAP-MLLM.

Background: Cancer remains one of the leading causes of morbidity and mortality worldwide. Comprehensive datasets that combine histopathological images with genetic and survival data across various tumour sites are essential for advancing computational pathology and personalised medicine. Results: We present SurGen, a dataset comprising 1,020 H&E-stained whole slide images (WSIs) from 843 colorectal cancer cases. The dataset includes detailed annotations for key genetic mutations (KRAS, NRAS, BRAF) and mismatch repair status, as well as survival data for 426 cases. To demonstrate SurGen's practical utility, we conducted a proof-of-concept machine learning experiment predicting mismatch repair status from the WSIs, achieving a test AUROC of 0.8316. These preliminary results underscore the dataset's potential to facilitate research in biomarker discovery, prognostic modelling, and advanced machine learning applications in colorectal cancer. Conclusions: SurGen offers a valuable resource for the scientific community, enabling studies that require high-quality WSIs linked with comprehensive clinical and genetic information on colorectal cancer. Our initial findings affirm the dataset's capacity to advance diagnostic precision and foster the development of personalised treatment strategies in colorectal oncology. Data available online at https://doi.org/10.6019/S-BIAD1285.

Clinical trials drive improvements in cancer treatments and outcomes. However, most adults with cancer do not participate in trials, and trials often fail to enroll enough patients to answer their scientific questions. Artificial intelligence could accelerate matching of patients to appropriate clinical trials. Here, we describe the development and evaluation of the MatchMiner-AI pipeline for clinical trial searching and ranking. MatchMiner-AI focuses on matching patients to potential trials based on core criteria describing clinical "spaces," or disease contexts, targeted by a trial. It aims to accelerate the human work of identifying potential matches, not to fully automate trial screening. The pipeline includes modules for extraction of key information from a patient's longitudinal electronic health record; rapid ranking of candidate trial-patient matches based on embeddings in vector space; and classification of whether a candidate match represents a reasonable clinical consideration. Code and synthetic data are available at https://huggingface.co/ksg-dfci/MatchMiner-AI . Model weights based on synthetic data are available at https://huggingface.co/ksg-dfci/TrialSpace and https://huggingface.co/ksg-dfci/TrialChecker . A simple cancer clinical trial search engine to demonstrate pipeline components is available at https://huggingface.co/spaces/ksg-dfci/trial_search_alpha .

Providing effective treatment and making informed clinical decisions are essential goals of modern medicine and clinical care. We are interested in simulating disease dynamics for clinical decision-making, leveraging recent advances in large generative models. To this end, we introduce the Medical World Model (MeWM), the first world model in medicine that visually predicts future disease states based on clinical decisions. MeWM comprises (i) vision-language models to serve as policy models, and (ii) tumor generative models as dynamics models. The policy model generates action plans, such as clinical treatments, while the dynamics model simulates tumor progression or regression under given treatment conditions. Building on this, we propose the inverse dynamics model that applies survival analysis to the simulated post-treatment tumor, enabling the evaluation of treatment efficacy and the selection of the optimal clinical action plan. As a result, the proposed MeWM simulates disease dynamics by synthesizing post-treatment tumors, with state-of-the-art specificity in Turing tests evaluated by radiologists. Simultaneously, its inverse dynamics model outperforms medical-specialized GPTs in optimizing individualized treatment protocols across all metrics. Notably, MeWM improves clinical decision-making for interventional physicians, boosting F1-score in selecting the optimal TACE protocol by 13%, paving the way for future integration of medical world models as the second readers.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

In this paper, we introduce a unified and generalist Biomedical Generative Pre-trained Transformer (BiomedGPT) model, which leverages self-supervision on large and diverse datasets to accept multi-modal inputs and perform a range of downstream tasks. Our experiments demonstrate that BiomedGPT delivers expansive and inclusive representations of biomedical data, outperforming the majority of preceding state-of-the-art models across five distinct tasks with 20 public datasets spanning over 15 unique biomedical modalities. Through the ablation study, we also showcase the efficacy of our multi-modal and multi-task pretraining approach in transferring knowledge to previously unseen data. Overall, our work presents a significant step forward in developing unified and generalist models for biomedicine, with far-reaching implications for improving healthcare outcomes.

The deployment of large language models (LLMs) in mental health and other sensitive domains raises urgent questions about ethical reasoning, fairness, and responsible alignment. Yet, existing benchmarks for moral and clinical decision-making do not adequately capture the unique ethical dilemmas encountered in mental health practice, where confidentiality, autonomy, beneficence, and bias frequently intersect. To address this gap, we introduce Ethical Reasoning in Mental Health (EthicsMH), a pilot dataset of 125 scenarios designed to evaluate how AI systems navigate ethically charged situations in therapeutic and psychiatric contexts. Each scenario is enriched with structured fields, including multiple decision options, expert-aligned reasoning, expected model behavior, real-world impact, and multi-stakeholder viewpoints. This structure enables evaluation not only of decision accuracy but also of explanation quality and alignment with professional norms. Although modest in scale and developed with model-assisted generation, EthicsMH establishes a task framework that bridges AI ethics and mental health decision-making. By releasing this dataset, we aim to provide a seed resource that can be expanded through community and expert contributions, fostering the development of AI systems capable of responsibly handling some of society's most delicate decisions.

Faithfully personalizing large language models (LLMs) to align with individual user preferences is a critical but challenging task. While supervised fine-tuning (SFT) quickly reaches a performance plateau, standard reinforcement learning from human feedback (RLHF) also struggles with the nuances of personalization. Scalar-based reward models are prone to reward hacking which leads to verbose and superficially personalized responses. To address these limitations, we propose Critique-Post-Edit, a robust reinforcement learning framework that enables more faithful and controllable personalization. Our framework integrates two key components: (1) a Personalized Generative Reward Model (GRM) that provides multi-dimensional scores and textual critiques to resist reward hacking, and (2) a Critique-Post-Edit mechanism where the policy model revises its own outputs based on these critiques for more targeted and efficient learning. Under a rigorous length-controlled evaluation, our method substantially outperforms standard PPO on personalization benchmarks. Personalized Qwen2.5-7B achieves an average 11\% win-rate improvement, and personalized Qwen2.5-14B model surpasses the performance of GPT-4.1. These results demonstrate a practical path to faithful, efficient, and controllable personalization.

We aim to present a comprehensive overview of the latest advancements in utilizing Large Language Models (LLMs) within the healthcare sector, emphasizing their transformative impact across various medical domains. LLMs have become pivotal in supporting healthcare, including physicians, healthcare providers, and patients. Our review provides insight into the applications of Large Language Models (LLMs) in healthcare, specifically focusing on diagnostic and treatment-related functionalities. We shed light on how LLMs are applied in cancer care, dermatology, dental care, neurodegenerative disorders, and mental health, highlighting their innovative contributions to medical diagnostics and patient care. Throughout our analysis, we explore the challenges and opportunities associated with integrating LLMs in healthcare, recognizing their potential across various medical specialties despite existing limitations. Additionally, we offer an overview of handling diverse data types within the medical field.

The advent of large language models marks a revolutionary breakthrough in artificial intelligence. With the unprecedented scale of training and model parameters, the capability of large language models has been dramatically improved, leading to human-like performances in understanding, language synthesizing, and common-sense reasoning, etc. Such a major leap-forward in general AI capacity will change the pattern of how personalization is conducted. For one thing, it will reform the way of interaction between humans and personalization systems. Instead of being a passive medium of information filtering, large language models present the foundation for active user engagement. On top of such a new foundation, user requests can be proactively explored, and user's required information can be delivered in a natural and explainable way. For another thing, it will also considerably expand the scope of personalization, making it grow from the sole function of collecting personalized information to the compound function of providing personalized services. By leveraging large language models as general-purpose interface, the personalization systems may compile user requests into plans, calls the functions of external tools to execute the plans, and integrate the tools' outputs to complete the end-to-end personalization tasks. Today, large language models are still being developed, whereas the application in personalization is largely unexplored. Therefore, we consider it to be the right time to review the challenges in personalization and the opportunities to address them with LLMs. In particular, we dedicate this perspective paper to the discussion of the following aspects: the development and challenges for the existing personalization system, the newly emerged capabilities of large language models, and the potential ways of making use of large language models for personalization.

Personalized image generation with text-to-image diffusion models generates unseen images based on reference image content. Zero-shot adapter methods such as IP-Adapter and OminiControl are especially interesting because they do not require test-time fine-tuning. However, they struggle to balance preserving personalized content and adherence to the text prompt. We identify a critical design flaw resulting in this performance gap: current adapters inadequately integrate personalization images with the textual descriptions. The generated images, therefore, replicate the personalized content rather than adhere to the text prompt instructions. Yet the base text-to-image has strong conceptual understanding capabilities that can be leveraged. We propose Conceptrol, a simple yet effective framework that enhances zero-shot adapters without adding computational overhead. Conceptrol constrains the attention of visual specification with a textual concept mask that improves subject-driven generation capabilities. It achieves as much as 89% improvement on personalization benchmarks over the vanilla IP-Adapter and can even outperform fine-tuning approaches such as Dreambooth LoRA. The source code is available at https://github.com/QY-H00/Conceptrol.

We introduce a novel contextual embedding model med-gte-hybrid that was derived from the gte-large sentence transformer to extract information from unstructured clinical narratives. Our model tuning strategy for med-gte-hybrid combines contrastive learning and a denoising autoencoder. To evaluate the performance of med-gte-hybrid, we investigate several clinical prediction tasks in large patient cohorts extracted from the MIMIC-IV dataset, including Chronic Kidney Disease (CKD) patient prognosis, estimated glomerular filtration rate (eGFR) prediction, and patient mortality prediction. Furthermore, we demonstrate that the med-gte-hybrid model improves patient stratification, clustering, and text retrieval, thus outperforms current state-of-the-art models on the Massive Text Embedding Benchmark (MTEB). While some of our evaluations focus on CKD, our hybrid tuning of sentence transformers could be transferred to other medical domains and has the potential to improve clinical decision-making and personalised treatment pathways in various healthcare applications.

Recent calls for pluralistic alignment of Large Language Models (LLMs) encourage adapting models to diverse user preferences. However, most prior work on personalized reward models heavily rely on additional identity information, such as demographic details or a predefined set of preference categories. To this end, we introduce SynthesizeMe, an approach to inducing synthetic user personas from user interactions for personalized reward modeling. SynthesizeMe first generates and verifies reasoning to explain user preferences, then induces synthetic user personas from that reasoning, and finally filters to informative prior user interactions in order to build personalized prompts for a particular user. We show that using SynthesizeMe induced prompts improves personalized LLM-as-a-judge accuracy by 4.4% on Chatbot Arena. Combining SynthesizeMe derived prompts with a reward model achieves top performance on PersonalRewardBench: a new curation of user-stratified interactions with chatbots collected from 854 users of Chatbot Arena and PRISM.