arXiv subjects

Amir M. Rahmani

Publications and source records attributed to Amir M. Rahmani.

At least 19 recordsLinked to original sources

arXiv2026

CARD: Cluster-level Adaptation with Reward-guided Decoding for Personalized Text Generation

Adapting large language models to individual users remains challenging due to the tension between fine-grained personalization and scalable deployment. We present CARD, a hierarchical framework that achieves effective personalization through progressive refinement. CARD first clusters users according to shared stylistic patterns and learns group-specific LoRA adapters, enabling robust generalization and strong low-resource performance. To capture individual differences within each cluster, we propose an implicit preference learning mechanism that contrasts user-authored text with cluster-level generations, allowing the model to infer user-specific style preferences without manual annotation. At inference time, CARD injects personalization exclusively at decoding via lightweight user preference vectors and low-rank logit corrections, while keeping the base model frozen. Experiments on the LaMP and LongLaMP benchmarks show that CARD achieves superior generation quality compared to baselines, while significantly improving efficiency and scalability for practical personalized text generation.

cs.AI↗

arXiv2026

Do Implicit Personalization and Explicit Styles Conflict? PsPLUG: A Lightweight Plug-in for Balancing Personalization and Style in Customized LLMs

Personalized large language models are often expected to follow explicit style instructions, yet we find that such instructions can undermine the user-specific characteristics that personalization methods aim to preserve. We call this failure mode personalization collapse: explicit style control can conflict with implicit user preferences. To address this challenge, we propose PsPLUG, a lightweight plug-in that learns a user-specific residual after accounting for the requested style. PsPLUG also allows us to tune personalization strength at inference time. Our experiments show that explicit style instructions can diminish personalization in existing methods, whereas PsPLUG better preserves user preferences while providing precise control over the balance between personalization and style adherence.

cs.AI↗

arXiv2026

Explainable Prediction from Mobile Sensing Data through LLM-guided Concept Integration

Mobile sensing enables longitudinal monitoring of behavioral and physiological patterns in everyday settings. However, accurate prediction remains challenging in small-cohort health-sensing studies, where task-specific outcome supervision is limited relative to heterogeneous sensing data. Interpretability is also important, as model outputs should reflect meaningful behavioral and physiological patterns rather than predictive scores alone. We develop a Concept-Integrated Transformer (CIT) with LLM-guided concept supervision for explainable prediction from mobile sensing data. CIT uses a pretrained large language model to generate baseline-aware concept abnormality targets with confidence weights without manual concept annotation. Across two longitudinal datasets, CIT achieves the highest F1 score on AFFECT (0.756) and ties for the highest on a PHQ-9 dataset (0.765). The learned concept scores also reveal interpretable behavioral and physiological patterns; in AFFECT, sleep quantity and quality show the clearest difference between high and low negative affect groups. These findings support LLM-guided concept integration for accurate and interpretable prediction in small-cohort mobile sensing studies.

cs.LG↗

arXiv2026

Beyond AHI: An Interpretable Causal-Discovery-Guided Framework for Sleep Recovery in Connected Health

Objective sleep assessment relies on polysomnography (PSG), yet clinical impact is often better reflected in patient-reported outcomes (PROs) such as sleepiness and fatigue. Existing summary indices, including the Apnea-Hypopnea Index (AHI), provide limited insight into the multidomain physiology underlying functional recovery. We propose an interpretable, causal-discovery-guided framework for deriving a hierarchical Sleep Recovery Score (SRS) from multimodal PSG. Using two large population cohorts (MESA: $n=1{,}540$; MrOS: $n=825$), we apply directed acyclic graph (DAG) learning to identify candidate physiological drivers spanning respiratory burden, hypoxic burden, sleep fragmentation, sleep architecture, and autonomic regulation. Although derived from clinical PSG, these domains map naturally to sensing streams increasingly available in connected health technologies, including wearable ECG, oximetry, and sleep-stage estimation devices. To preserve mechanistic plausibility, we introduce a two-stage screening process that combines physiology-based constraints with constrained LLM-assisted auditing to identify and remove structural confounders and construct-overlapping variables. Across cohorts, these five domains emerge as recurrent physiological domains associated with recovery, and the resulting SRS shows up to $3.4\times$ stronger alignment with perceived recovery than AHI. By linking multimodal sleep physiology to patient-centered outcomes through an interpretable, bias-aware, and domain-structured framework, this work provides a practical foundation for recovery modeling across both clinical sleep studies and emerging smart and connected health settings.

cs.LG↗

arXiv2026

Event-Aligned Analysis of Multi-Rater Pain Assessments Using Continuous Wearable Physiology

Pain is assessed differently by patients, nurses, and clinicians, yet most computational approaches assume a single ground-truth label - effectively ignoring who is doing the rating. We introduce a rater-aware, event-aligned framework that converts sparse, rater-specific pain ratings into discrete pain-change events and aligns continuous wearable physiological signals to these events, preserving rater identity throughout. Applied to multimodal wearable data collected during spine-related pain procedures, the framework identifies substantial disagreement across rater groups and provides preliminary, exploratory evidence of rater-dependent physiological differences preceding reported pain increases. These findings suggest that pain-physiology relationships may not be rater-invariant, and that aggregating assessments across raters may mask meaningful physiological patterns. A rater-aware, event-aligned perspective is therefore a promising direction for interpreting wearable data in real-world clinical pain assessment.

stat.AP↗

arXiv2026

A knowledge-guided agentic framework for mitigating patient-context ambiguity in health queries

Patients often submit short, underspecified queries to healthcare chatbots that lack the patient-specific information needed to determine an appropriate response. Although these queries may be linguistically clear, they can support multiple plausible answers depending on undisclosed factors such as symptoms, diagnoses, medications, allergies, or dietary restrictions. A language model answering such a query directly may therefore rely on unsupported assumptions about the patient. We introduce a knowledge-guided agentic framework for mitigating patient-context ambiguity before final response generation. The framework operates between the patient and an otherwise unchanged downstream language model. It interprets the initial query, uses a task-specific knowledge graph to construct a set of plausible hypotheses, identifies the missing patient-context variables needed to distinguish among them, and asks targeted follow-up questions. The original query and the acquired context are then combined into a clarified prompt for the downstream model. We evaluated the framework across five language models using two controlled ambiguity-mitigation benchmarks: diagnosis retrieval from 1,034 symptom queries with clinically relevant evidence systematically masked, and dietary-safety classification from 487 queries with decisive health context omitted. The framework was compared with direct answering of the underspecified query and with rephrasing the same query without acquiring new patient information. In diagnosis retrieval, it increased overall exact Top-1 accuracy by at least 57.1 percentage points and selective exact Recall@5 by at least 77.7 percentage points across the five evaluated models compared with direct prompting. In dietary-safety classification, it improved accuracy across all five models and achieved the highest Matthews correlation coefficient for four...

cs.CL↗

arXiv2026

When Clean Signals Are Not Enough: Detecting Structural Ambiguity for Safe Wearable Stress Classification

Wearable stress classifiers can achieve strong average performance while failing completely for a particular individual. On WESAD, a Random Forest reaches 93.0% mean accuracy yet yields F1 = 0 for Subject 14, whose cross-signal coupling weakens near stress onset. We call this structural ambiguity: individually plausible physiological channels form an inter-signal pattern that is poorly supported by the person's non-stress reference. We introduce the Individual Conformal Coupling Monitor (ICCM), a lightweight and transparent pre-inference monitor that quantifies subject-specific coupling divergence and routes each window to classify, defer, or abstain without retraining the downstream classifier. Across WESAD (N = 15) and Stress-Predict (N = 35), full-cohort Pearson associations between ambiguity and accuracy are negative (r = -0.607, p = 0.016; r = -0.412, p = 0.014). Robustness analyses temper this finding: rank correlations are not significant, and the WESAD association disappears when Subject 14 is removed. ICCM changes false-positive counts from 29 to 27 and 94 to 92, although neither paired change is significant. It withholds 3 of Subject 14's 21 stress windows but does not repair the missed-stress failure. These results position ICCM as an interpretable signal of unsupported physiology and individual failure, rather than a stand-alone safety guarantee.

cs.AI↗

arXiv2026

GoT-CD: Graph-of-Thoughts Causal Discovery and the Fragility of Post-hoc Path-Specific Fairness Audits

Causal discovery recovers directed structure from observational data and is increasingly used in clinical settings to support mechanism reasoning and fairness audits of predictive models. Path-specific counterfactual fairness asks whether a protected attribute influences an outcome through illegitimate pathways, but these estimands are defined relative to a supplied causal graph and therefore inherit whatever errors the discovery step introduces. Discovery methods are routinely scored on aggregate structural metrics that weight all edges equally, and no established evaluation asks whether the specific pathway an audit depends on survives discovery---or what the audit reports when that pathway is missing. Here we show that full-graph Graph-of-Thoughts reasoning yields acyclic discovered graphs that are structurally competitive with large language model (LLM) baselines, yet that structural fidelity alone does not guarantee fairness-faithful audits. We introduce GoT-CD, in which the reasoning unit is a complete candidate edge set: multiple graphs are generated in parallel, scored by a deterministic validity function, and merged under a hard union constraint that forbids invented edges, with greedy projection enforcing a DAG before commitment. GoT-CD returns a valid DAG on all five reported benchmarks and achieves the best DAG-valid F1 score among LLM methods on Asia, Alzheimer's, and COVID-Respiratory datasets. On an Alzheimer's benchmark with known unfair path, a post-hoc path-specific audit shows that five of eight discovered graphs recover no path from the sensitive attribute to the outcome and therefore report a null overall effect while mediated effects persist, necessitating downstream path-specific fairness analysis along with structural discovery.

cs.LG↗

arXiv2026

FairDiffuseVQVAE: Sampling-Time Fairness in Tabular Diffusion via Conditional Refinement of Vector-Quantized Latents

Synthetic tabular data is increasingly used in privacy-preserving data sharing, data augmentation, and to mitigate downstream classifier bias. State-of-the-art tabular diffusion models such as TabDDPM and TabSyn achieve excellent distributional fidelity but offer no mechanism for fairness; conversely, fairness-aware tabular generators (DECAF, FairTGAN, FairTabDDPM) impose explicit fairness penalties at training time, yielding modest fairness gains at substantial cost to either sample quality or downstream utility. We introduce FairDiffuseVQVAE, a two-stage architecture that decouples fidelity from fairness: a vector-quantized autoencoder with a row-level discriminator (Stage~1, no fairness terms) is followed by a DiffuseVAE-style continuous diffusion refiner that conditions on both the Stage-1 reconstruction and the protected attribute via classifier-free guidance (Stage~2). Fairness emerges as a property of the sampling distribution -- uniform sampling of the protected attribute at inference time enforces demographic parity by construction, rather than from competing loss terms. On the Adult, Bank and COMPAS datasets, FairDiffuseVQVAE achieves the highest mean Demographic Parity Ratio ($0.702$, $+47\%$ over FairTabDDPM) and Equalized Odds Ratio ($0.686$, $+100\%$). It also attains the lowest mean pair-wise correlation error ($0.034$) of any published method, while explicitly trading $\sim$$15$ AUC points for these fairness gains.

cs.LG↗

arXiv2026

PerCaM-Health: Personalized Dynamic Causal Graphs for Healthcare Reasoning

Personalized healthcare decisions require reasoning about how physiological and behavioral variables influence an individual patient over time. Existing temporal causal discovery methods are poorly matched to this setting: cohort-level models provide stable but non-personalized structures, while per-patient discovery is unreliable because individual trajectories are short, noisy, irregular, and non-stationary. This creates a fundamental gap between population-level causal modeling and the patient-specific, time-varying mechanisms needed for intervention reasoning. We introduce PerCaM-Health, a framework for learning personalized dynamic causal graphs from longitudinal health data. The framework learns a knowledge-guided population temporal graph, then conservatively adapts and evolves it using patient-specific temporal evidence and rolling-window updates, producing interpretable and auditable graph sequences. By coupling these graphs with temporal structural equations, the framework enables patient-level counterfactual queries, such as estimating short-horizon outcome changes under hypothetical behavioral interventions. Experiments on a semi-synthetic dynamic health benchmark show that PerCaM-Health improves graph recovery, dynamic edge tracking, and intervention direction accuracy compared to cohort-level, per-patient, and non-personalized temporal baselines. These results demonstrate that jointly modeling personalization and temporal evolution yields more reliable causal structure and intervention reasoning.

cs.LG↗

arXiv2026

Memisis: Orchestrating and Evaluating Synthetic Data for Tabular Health Datasets

Synthetic data is widely used in healthcare to create datasets that preserve statistical properties of real data without exposing sensitive patient information. Generating and evaluating synthetic data across privacy, utility, and fairness dimensions is crucial for enabling high-quality data availability in downstream prediction tasks and clinical decision making. We present \textbf{Memisis}, a tool that orchestrates and evaluates synthetic data by leveraging existing synthesis libraries, large language models (LLMs), and state-of-the-art evaluation metrics. Our tool creates a unified workflow for data generation, validation, and evaluation. Users can control training size, training epochs, and the number of synthetic rows to sample. Beyond manual configuration, an interactive agent mode allows users to specify data generation goals in natural language, and the tool orchestrates the full pipeline by invoking existing synthesizers while performing the requisite evaluation. For the demo, we use an open-source schizophrenia dataset with protected attributes related to race and gender, evaluate six synthesizers spanning GANs, VAEs, diffusion models, and normalizing flows, and use a local LLM to orchestrate the workflow. The system affords users flexibility and control over the data generation and evaluation process.

cs.LG↗

arXiv2026

From Sounds to Scenes: A Benchmark for Evaluating Context-Aware Auditory Scene Understanding in Large Audio Language Models

Recent Large Audio Language Models (LALMs) have achieved remarkable progress in audio perceptual tasks across individual acoustic layers, including speech, sound, and music. However, existing benchmarks predominantly evaluate these layers in isolation, overlooking the complex contextual relationships that arise when multiple acoustic sources co-occur in real-world auditory scenes. Real-world auditory interpretation requires Context-Aware Auditory Scene Understanding (CASU): the ability to comprehend the holistic scene by integrating sound layers. To evaluate this capability, we introduce the CASU benchmark, which assesses whether Audio LLMs can interpret auditory scenes composed of speech, acoustic events (e.g., announcements), and background environments (e.g., traffic), and reason about the logical relationships between these layers. We propose a scalable pipeline for constructing time-accurate, semi-synthetic audio streams by composing real-world scene sounds with synthetic speech. Building on this data, we design four tasks that probe scene understanding: contextual question answering, entity extraction from the scene, speaker role inference, and counterfactual reasoning where scene is manipulated. Experiments across multiple LALMs demonstrate that effective auditory scene understanding requires integration over all auditory layers, rather than reliance on speech or sound alone, underscoring the necessity of CASU for advancing complex audio understanding in LALMs.

cs.SD↗

arXiv2026

T2D-Bench: Evidence-Gated Evaluation of LLM Outputs for Type 2 Diabetes Using a Multi-Layer Clinical-Lifestyle Knowledge Graph

Large language models (LLMs) can produce clinically fluent recommendations for type 2 diabetes while failing to satisfy guideline constraints or explicitly justify lifestyle-related glycemic claims. We present T2D-Bench, a reproducible benchmark and evidence-gated evaluation framework for testing whether LLM outputs satisfy explicit, graph-checkable evidence requirements. T2D-Bench is built on a multi-layer clinical-lifestyle knowledge graph that combines a biomedical spine (UMLS, DrugBank, SIDER), computable ADA Standards of Care rules, and lifestyle knowledge connected through a mechanistic bridge to glycemic laboratory effects. Across 100 structured vignettes spanning diagnosis, medication safety, and adversarial lifestyle conflicts, baseline outputs failed benchmark-defined evidence-path checks in 35% of cases for GPT-4o-mini and 33% for GPT-4o. The evidence gate detects unsupported omissions and uses constrained revision to bring outputs into verifier-level compliance with benchmark-defined evidence requirements. These results show that computable evidence constraints can make unsupported clinical omissions explicit, measurable, and correctable in diabetes-focused LLM outputs.

cs.AI↗

arXiv2026

AP-GRPO: Anchor-Gated Phonetic Alignment with Policy Optimization for Pathological Speech Reconstruction

Pathological speech from patients with neurodegenerative and neuromotor disorders is often acoustically distorted and linguistically fragmented, making pathological speech reconstruction necessary to recover intended textual content from distorted and incomplete speech recordings. Crucially, such recordings are rarely uniformly degraded: some words or short phrases remain reliable and can serve as audible anchors for reconstructing the corrupted surrounding content. We introduce Anchor-gated Phonetic Group Relative Policy Optimization (AP-GRPO), a GRPO framework with phonetic reward that aligns speech language models (SLMs) through audible-anchor preservation and inter-anchor phonetic compatibility to the original speech signal. AP-GRPO consists of: (i) an anchor-gated reward that matches reliable audible anchors in clear regions; and (ii) an inter-anchor phonetic alignment reward that evaluates whether recovered contents are phonetically supported by the corresponding corrupted inter-anchor speech span. Across four disease conditions, AP-GRPO improves faithful speech reconstruction, and the learned anchor constraint automatically adapts to each condition and thus reveals interpretable disease-specific profiles: conditions with severe articulatory degradation require stronger anchor enforcement, whereas milder impairment or linguistically impaired conditions rely more on phonetic alignment for inter-anchor recovery.

cs.SD↗

arXiv2026

Can the Environment Speak for Itself? $T^{2}$-GRPO: A Turn-Trajectory Group Relative Policy Optimization for Caregiver Agents

Optimizing large language models (LLMs) for long-horizon caregiver agents requires balancing delayed task objectives with immediate environment dynamics, such as patient distress and resistance. In dementia care, this balance is especially difficult: trajectory level rewards are too sparse for turn level credit assignment, while external LLM-based evaluators are costly and can misread fragmented or indirect patient responses. To address this issue, we propose \textbf{T}urn-\textbf{T}rajectory \textbf{G}roup \textbf{R}elative \textbf{P}olicy \textbf{O}ptimization (\textbf{T$^{2}$-GRPO}), a framework that decouples caregiver RL into two normalized reward horizons and enforces safety through a binary hard veto. $T^2$-GRPO derives dense turn-level rewards directly from environment state transitions, measuring changes in patient distress and resistance from a frozen dementia patient simulator. These environment-grounded rewards are combined with trajectory-level evaluations through independent centered-rank normalization, which preserves heterogeneous reward signals and mitigates reward collapse. Extensive experiments on dementia caregivers show that T $^{2}$-GRPO outperforms competitive baselines, indicating a substantial improvement for emotionally sensitive caregiver scenarios that effectively handles immediate patient feedback, long-term care outcomes, and safety constraints.

cs.AI↗

arXiv2026

Personalized Digital Health Modeling with Adaptive Support Users

Personalized models are essential in digital health because individuals exhibit substantial physiological and behavioral heterogeneity. Yet personalization is limited by scarce and noisy user-specific data. Most existing methods rely on population pretraining or data from similar users only, which can lead to biased transfer and weak generalization. We propose a unified personalization framework that trains a personal model using adaptively weighted support users, including both similar and dissimilar individuals. The objective integrates personal loss, similarity-weighted transfer from similar users, and contrastive regularization from dissimilar users to suppress misleading correlations. An iterative optimization algorithm jointly updates model parameters and user similarity weights. Experiments on six tasks across four real-world digital health datasets show consistent improvements over population and personalized baselines. The method achieves up to 10% lower RMSE on large-scale datasets and approximately 25% lower RMSE in low-data settings. The learned adaptive weights improve data efficiency and provide interpretable guidance for targeted data selection.

cs.AI↗

arXiv2026

Query-Conditioned Graph Retrieval for Contextualized LLM Reasoning in Personalized Wearable Data

Large language models (LLMs) are increasingly applied to analyzing wearable sensing data, which are long-term, multimodal, and highly personalized. A key challenge is context selection: providing insufficient context limits reasoning, while including all available data leads to inefficiency and degraded generation quality. We propose Wearable As Graph (WAG), a graph-based context retrieval framework that enables query-adaptive reasoning over wearable data with LLMs. WAG organizes wearable metrics and user-specific signals into a personalized knowledge graph, and retrieves a query-conditioned subgraph to support downstream generation. The retrieval process integrates global relationships, capturing prior knowledge and population- and individual-level patterns via hierarchical Bayesian modeling, with local relationships that reflect short-term signal deviations. A query openness signal further controls retrieval breadth. We evaluate WAG on over 10,000 data-grounded queries from real-world wearable datasets. Across LLM-based and human evaluations, WAG achieves an approximately 70% win rate over baseline and standard RAG methods, demonstrating the effectiveness of structured, query-adaptive context retrieval for LLM-driven analysis of wearable data.

cs.IR↗

arXiv2026

Evaluating Causal Discovery Algorithms for Path-Specific Fairness and Utility in Healthcare

Causal discovery in health data faces evaluation challenges when ground truth is unknown. We address this by collaborating with experts to construct proxy ground-truth graphs, establishing benchmarks for synthetic Alzheimer's disease and heart failure clinical records data. We evaluate the Peter-Clark, Greedy Equivalence Search, and Fast Causal Inference algorithms on structural recovery and path-specific fairness decomposition, going beyond composite fairness scores. On synthetic data, Peter-Clark achieved the best structural recovery. On heart failure data, Fast Causal Inference achieved the highest utility. For path-specific effects, ejection fraction contributed 3.37 percentage points to the indirect effect in the ground truth. These differences drove variations in the fairness-utility ratio across algorithms. Our results highlight the need for graph-aware fairness evaluation and fine-grained path-specific analysis when deploying causal discovery in clinical applications.

cs.LG↗