arXiv subjects

Eric Horvitz

Publications and source records attributed to Eric Horvitz.

At least 19 recordsLinked to original sources

arXiv2026

RadFusion: Towards Threshold-Controllable Radiology Report Generation

Automated radiology report generation is advancing rapidly in response to the shortage of radiologists, yet unlike a perception model, existing generation models offer no control over the sensitivity-specificity trade-off of their diagnostic content. Such control is essential because clinical scenarios diverge: emergency triage prioritizes sensitivity to reduce missed findings, whereas confirmatory interpretation emphasizes specificity to limit unnecessary interventions. A single fixed report can neither adapt to these scenarios nor support the ROC-based validation widely expected for regulatory clearance. We introduce RadFusion, a framework that equips report generation with threshold controllability. Our method fuses a multi-label classifier, which provides per-disease confidence scores, with a VQA-based report generator, which describes medical findings in detail; an LLM then rewrites the report so that its stated diagnoses follow the classifier's decisions at the selected threshold while staying grounded in the generator's descriptions. On MIMIC-CXR, the performance of RadFusion conforms to the classifier's ROC curve: sweeping the threshold and mapping the reports back to class labels reproduces the classifier's validated ROC performance. This conformance makes generated reports quantitatively evaluable through ROC analysis, strengthening the case for regulatory clearance, and enables operating-point selection that matches report behavior to clinical context. Moreover, combining the two model types improves diagnostic accuracy over uncontrolled generation: sensitivity increases by 6.9% at matched specificity, and specificity by 20.7% at matched sensitivity. These results show that RadFusion makes report generation clinically adaptable, quantitatively verifiable, and diagnostically more reliable.

cs.AI↗

arXiv2026

High-Stakes Decisions with Language Models: Insights from Emergency Triage

High-stakes decisions under uncertainty, such as medical emergency triage, require more than accurate predictions. They depend on estimating the likelihood of alternative outcomes while explicitly weighing the consequences of different actions, principles that have long formed the foundation of medical diagnosis and decision making. Yet language models are increasingly used for high-stakes clinical recommendations without explicit specification of the utilities governing these decisions. Here we show that emergency triage with language models can be understood within a probabilistic decision framework, providing a case study of a broader decision-analytic paradigm for steering, evaluating, and deploying language models in high-stakes settings. Using clinical vignettes from a structured evaluation of a consumer triage system, we analyze recommendations for treatment under alternative utility functions that specify the relative costs of missed emergencies and unnecessary escalation. We find that capable language models adjust recommendations in response to stated utilities, revealing that the same underlying predictions can support markedly different decision policies. These findings show that effective deployment depends not only on improving predictions but also on making decision objectives explicit. More broadly, they suggest that language models for high-stakes applications should be understood and evaluated as probabilistic decision systems whose recommendations depend jointly on predictive performance and explicit utilities.

cs.AI↗

arXiv2026

Psychological Influences of Conversational AI: Research and Design Directions for Reducing Harm and Promoting Well-Being

As conversational AI systems become increasingly integrated into daily life, their potential effects on user well-being require ongoing attention. While consumer-facing generalist models can provide benefits, including improved access to information, learning, productivity, self-reflection, and companionship, they also introduce risks, such as emotional entanglement, unhealthy dependence, and the amplification of psychological vulnerabilities. Drawing on prior research and empirical observations of AI chatbot behavior, we propose a set of aspirational directions for guiding the behavior of general-purpose AI systems in ways that may reduce potential psychological harms and support user well-being. We acknowledge the difficulty of systematically assessing the long-term impacts of AI chatbot use and frame these directions as hypotheses for studying how AI behavior may influence users across general interactions, role-playing scenarios, and contexts that could be characterized as providing psychological support. While some proposed directions are supported by existing research and expert insights, others identify open questions and areas requiring deeper study. We hope that this formulation and these hypotheses encourage further discussion, empirical investigation, and exploration of interactive design approaches aimed at better accommodating users' psychological needs and promoting their well-being.

cs.AI↗

arXiv2026

Can Revealed Preferences Clarify LLM Alignment and Steering?

LLMs are increasingly used to make or support high-stakes decisions under uncertainty, where alignment depends not only on factual accuracy but on how models weigh tradeoffs between different outcomes. We present an empirical pipeline for estimating the implied preferences that an LLM's observed choices optimize: we elicit the model's probability distribution over unknowns along with the choice it would make for the decision task and then fit a discrete choice model to recover the cost function that best rationalizes the model's decisions. We show how this revealed-preference description allows rigorous evaluation of whether models behave in a consistently goal-directed way, whether they can verbalize a description of their objectives which matches their revealed decision policy, and whether prompting can reliably steer those policies to implement a user-specified cost function. We apply this evaluation across four medical diagnosis domains and multiple frontier and open-source models. We find that while many models have a nontrivial degree of internal coherence, they also have significant weaknesses in faithfully reporting or adopting preferences in response to user direction.

cs.LG↗

arXiv2026

MEMENTO: Teaching LLMs to Manage Their Own Context

Reasoning models think in long, unstructured streams with no mechanism for compressing or organizing their own intermediate state. We introduce MEMENTO: a method that teaches models to segment reasoning into blocks, compress each block into a memento, i.e., a dense state summary, and reason forward by attending only to mementos, reducing context, KV cache, and compute. To train MEMENTO models, we release OpenMementos, a public dataset of 228K reasoning traces derived from OpenThoughts-v3, segmented and annotated with intermediate summaries. We show that a two-stage SFT recipe on OpenMementos is effective across different model families (Qwen3, Phi-4, Olmo 3) and scales (8B--32B parameters). Trained models maintain strong accuracy on math, science, and coding benchmarks while achieving ${\sim}2.5\times$ peak KV cache reduction. We extend vLLM to support our inference method, achieving ${\sim}1.75\times$ throughput improvement while also enabling us to perform RL and further improve accuracy. Finally, we identify a dual information stream: information from each reasoning block is carried both by the memento text and by the corresponding KV states, which retain implicit information from the original block. Removing this channel drops accuracy by 15\,pp on AIME24.

cs.AI↗

arXiv2026

Not Another EHR: Reimagining Physician Information Needs with Generative AI Technology

Electronic health records (EHRs) have improved data accessibility but have also introduced cognitive burden for physicians, given the sheer volume and complexity of the data involved. Advances in large language models (LLMs) create new opportunities to rethink how clinicians interact with medical data through dynamic, adaptive interfaces. In this position paper, we explore how generative AI can support physicians' information needs by enabling more dynamic interactions with patient data. Through semi-structured interviews with internal physicians at Microsoft, we identify key challenges in data navigation and synthesis, and characterize clinicians' information needs during diagnostic workflows. We further examine how physicians conceptualize AI can help their work process and how these mental models shape expectations for interaction and trust. Based on these insights, we discuss design considerations for generative user interfaces that support clinician-centered workflows.

cs.HC↗

arXiv2026

Clinician input steers AI toward accurate and harmful recommendations

Large language models (LLMs) are entering clinical workflows, yet evaluations rarely assess how clinician reasoning shapes model behavior during clinical interactions. Using 61 curated NEJM Case Records, we tested how expert or misleading clinician reasoning influenced AI-generated differential diagnoses and next step recommendations across 21 reasoning variants from 8 proprietary and open-source models. After clinician exposure, LLM-clinician concordance increased: simulations with >=3 overlapping differential diagnoses rose from 65.8% to 93.5%, and those with >=3 overlapping next step recommendations from 20.3% to 53.8%. Expert context significantly improved correct final-diagnosis inclusion in all 21 models (mean +20.4 pp), reflecting both improved reasoning and passive content echoing, while adversarial context significantly degraded performance in 14 models (mean -5.4 pp). Expert context also significantly increased leading-diagnosis accuracy in all 21 models, whereas adversarial context significantly reduced it in 13. Multi-turn disagreement challenges revealed distinct model phenotypes, from highly conformist to dogmatic, with adversarial arguments remaining a vulnerability even in otherwise resilient models. Inference-time scaling reduced harmful echoing of clinician-introduced recommendations across WHO harm-severity tiers by 62.7% for mild, 57.9% for moderate, 76.3% for severe, and 83.5% for death-tier recommendations. Inference-time prompting recovered diagnostic accuracy lost to adversarial context while preserving expert-context benefits across GPT-5, Claude Sonnet 4.5, and Gemini 3 Flash, and sharply reduced highly consistent harmful echoing across severity tiers. These findings provide a foundation for evaluating clinician-AI collaboration and introduce interactive metrics and mitigation strategies essential to safety and robustness.

cs.HC↗

arXiv2026

Media Integrity and Authentication: Status, Directions, and Futures

We provide background on emerging challenges and future directions with media integrity and authentication methods, focusing on distinguishing AI-generated media from authentic content captured by cameras and microphones. We evaluate several approaches, including provenance, watermarking, and fingerprinting. After defining each method, we analyze three representative technologies: cryptographically secured provenance, imperceptible watermarking, and soft-hash fingerprinting. We analyze how these tools operate across modalities and evaluate relevant threat models, attack categories, and real-world workflows spanning capture, editing, distribution, and verification. We consider sociotechnical reversal attacks that can invert integrity signals, making authentic content appear synthetic and vice versa, highlighting the value of verification systems that are resilient to both technical and psychosocial manipulation. Finally, we outline techniques for delivering high-confidence provenance authentication, including directions for strengthening edge-device security using secure enclaves.

cs.CR↗

arXiv2026

When Agents Say One Thing and Do Another: Validating Elicited Beliefs from LLMs

Large language models (LLMs) are increasingly deployed in high-stakes settings where good decisions require forming beliefs over the probability of unknown outcomes. However, it is unclear whether LLMs act as if they hold coherent beliefs when making decisions, or if so, how we could validate models' reports of such beliefs. We propose a decision-theoretic framework that elicits both probability judgments and decisions from an agent and tests their mutual consistency. Formally, our methods characterize whether it is possible for the actions to be produced by a ``near-rational" decision maker who holds the elicited probability as their true belief. We show that, perhaps surprisingly, this formalization implies empirically testable conditions even without any assumption about the agent's utility function. Applying our framework to stylized clinical diagnosis tasks, we find that models' reported beliefs are demonstrably imperfect summaries of the information revealed in their decisions, but that the discrepancies are small for the strongest models.

cs.AI↗

arXiv2025

The Collaboration Gap: Exploration and Benchmarking of Open-World Agentic Cooperation

The trajectory of AI development suggests that we will increasingly rely on agent-based systems powered by language models, composed of independently developed agents with different information, privileges, and tools. The success of these systems will depend critically on effective collaboration among these heterogeneous agents, even under partial observability. Despite intense interest, the literature lacks empirical studies evaluating agentic collaboration without relying on fixed communication protocols, limiting insights for open-world deployments. We propose an illustrative collaborative maze-solving benchmark that (i) isolates collaborative capabilities, (ii) modulates problem complexity, (iii) enables scalable automated grading, and (iv) imposes no output-format constraints, benchmarking unguided, natural communication. Using this benchmark, we evaluate 32 leading open- and closed-source models in solo, homogeneous, and heterogeneous pairings. Our results reveal a surprising collaboration gap: models that perform well solo often degrade substantially when required to collaborate. We identify mitigations that show remarkable influence. For example, a small nudge via a relay inference approach, where a stronger agent leads before handing off to a weaker one, closes much of the gap. Our findings argue for (1) collaboration-aware evaluation, (2) training strategies to enhance collaborative capabilities, and (3) deliberate interaction design to elicit agents' collaboration skills, principles relevant to AI-AI and human-AI settings where agents must establish common ground.

cs.AI↗

arXiv2025

Magentic Marketplace: An Open-Source Environment for Studying Agentic Markets

As LLM agents advance, they are increasingly mediating economic decisions, ranging from product discovery to transactions, on behalf of users. Such applications promise benefits but also raise many questions about agent accountability and value for users. Addressing these questions requires understanding how agents behave in realistic market conditions. However, previous research has largely evaluated agents in constrained settings, such as single-task marketplaces (e.g., negotiation) or structured two-agent interactions. Real-world markets are fundamentally different: they require agents to handle diverse economic activities and coordinate within large, dynamic ecosystems where multiple agents with opaque behaviors may engage in open-ended dialogues. To bridge this gap, we investigate two-sided agentic marketplaces where Assistant agents represent consumers and Service agents represent competing businesses. To study these interactions safely, we develop Magentic-Marketplace -- a simulated environment where Assistants and Services can operate. This environment enables us to study key market dynamics: the utility agents achieve, behavioral biases, vulnerability to manipulation, and how search mechanisms shape market outcomes. Our experiments show that frontier models can approach optimal welfare -- but only under ideal search conditions. Performance degrades sharply with scale, and all models exhibit severe first-proposal bias, creating 10-30x advantages for response speed over quality. These findings reveal how behaviors emerge across market conditions, informing the design of fair and efficient agentic marketplaces.

cs.MA↗

arXiv2025

Tandem Training for Language Models

As language models continue to rapidly improve, we can expect their actions and reasoning to become difficult or impossible for weaker agents and humans to follow, undermining interpretability and oversight. With an eye on long-term futures, we pursue methods that encourage models to produce solutions that remain intelligible to weaker collaborators. We formalize intelligibility as handoff robustness: a strong model's solution is intelligible to a weaker model if randomly handing off control to the weaker model along the solution path does not cause failure. Building on this criterion, we introduce tandem training for language models, a reinforcement learning (RL) paradigm in which rollout tokens are intermittently and randomly sampled from a frozen weak model rather than the strong model being trained. Because rollouts succeed only when the strong model's actions and reasoning process can be continued by the weak model -- when the two can co-construct a successful solution -- optimizing standard RL objectives with tandem training implicitly incentivizes both correctness and intelligibility. In the GSM8K math reasoning task, tandem training reliably teaches models to abandon jargon and adapt their language to weaker partners while keeping task accuracy high. Our results demonstrate a promising route to building AI systems that remain auditable by weaker agents, with implications for human--AI collaboration and multi-agent communication.

cs.AI↗

arXiv2025

Tracing the Traces: Latent Temporal Signals for Efficient and Accurate Reasoning

Reasoning models improve their problem-solving ability through inference-time scaling, allocating more compute via longer token budgets. Identifying which reasoning traces are likely to succeed remains a key opportunity: reliably predicting productive paths can substantially reduce wasted computation and improve overall efficiency. We introduce Latent-Trajectory signals that characterize the temporal evolution of a model's internal representations during the generation of intermediate reasoning tokens. By measuring the overall change in latent representations between the start and end of reasoning, the change accumulated across intermediate steps, and the extent to which these changes advance toward the final state, we show that these signals predict solution accuracy more reliably than both cross-layer metrics and output-based confidence measures. When used to guide answer selection across multiple sampled generations, Latent-Trajectory signals make test-time scaling more effective and efficient than majority voting, reducing token usage by up to 70% while preserving and even improving accuracy by 2.6% on average. Moreover, these predictive signals often emerge early in the reasoning trace, enabling early selection and allocation of compute to the most promising candidates. Our findings contribute not only practical strategies for inference-time efficiency, but also a deeper interpretability perspective on how reasoning processes are represented and differentiated in latent space.

cs.AI↗

arXiv2025

The Illusion of Readiness in Health AI

Large language models have demonstrated remarkable performance in a wide range of medical benchmarks. Yet underneath the seemingly promising results lie salient growth areas, especially in cutting-edge frontiers such as multimodal reasoning. In this paper, we introduce a series of adversarial stress tests to systematically assess the robustness of flagship models and medical benchmarks. Our study reveals prevalent brittleness in the presence of simple adversarial transformations: leading systems can guess the right answer even with key inputs removed, yet may get confused by the slightest prompt alterations, while fabricating convincing yet flawed reasoning traces. Using clinician-guided rubrics, we demonstrate that popular medical benchmarks vary widely in what they truly measure. Our study reveals significant competency gaps of frontier AI in attaining real-world readiness for health applications. If we want AI to earn trust in healthcare, we must demand more than leaderboard wins and must hold AI systems accountable to ensure robustness, sound reasoning, and alignment with real medical demands.

cs.AI↗

arXiv2025

CancerGUIDE: Cancer Guideline Understanding via Internal Disagreement Estimation

The National Comprehensive Cancer Network (NCCN) provides evidence-based guidelines for cancer treatment. Translating complex patient presentations into guideline-compliant treatment recommendations is time-intensive, requires specialized expertise, and is prone to error. Advances in large language model (LLM) capabilities promise to reduce the time required to generate treatment recommendations and improve accuracy. We present an LLM agent-based approach to automatically generate guideline-concordant treatment trajectories for patients with non-small cell lung cancer (NSCLC). Our contributions are threefold. First, we construct a novel longitudinal dataset of 121 cases of NSCLC patients that includes clinical encounters, diagnostic results, and medical histories, each expertly annotated with the corresponding NCCN guideline trajectories by board-certified oncologists. Second, we demonstrate that existing LLMs possess domain-specific knowledge that enables high-quality proxy benchmark generation for both model development and evaluation, achieving strong correlation (Spearman coefficient r=0.88, RMSE = 0.08) with expert-annotated benchmarks. Third, we develop a hybrid approach combining expensive human annotations with model consistency information to create both the agent framework that predicts the relevant guidelines for a patient, as well as a meta-classifier that verifies prediction accuracy with calibrated confidence scores for treatment recommendations (AUROC=0.800), a critical capability for communicating the accuracy of outputs, custom-tailoring tradeoffs in performance, and supporting regulatory compliance. This work establishes a framework for clinically viable LLM-based guideline adherence systems that balance accuracy, interpretability, and regulatory requirements while reducing annotation costs, providing a scalable pathway toward automated clinical decision support.

cs.LG↗

arXiv2025

Sequential Diagnosis with Language Models

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

cs.CL↗

arXiv2025

MedHELM: Holistic Evaluation of Large Language Models for Medical Tasks

While large language models (LLMs) achieve near-perfect scores on medical licensing exams, these evaluations inadequately reflect the complexity and diversity of real-world clinical practice. We introduce MedHELM, an extensible evaluation framework for assessing LLM performance for medical tasks with three key contributions. First, a clinician-validated taxonomy spanning 5 categories, 22 subcategories, and 121 tasks developed with 29 clinicians. Second, a comprehensive benchmark suite comprising 35 benchmarks (17 existing, 18 newly formulated) providing complete coverage of all categories and subcategories in the taxonomy. Third, a systematic comparison of LLMs with improved evaluation methods (using an LLM-jury) and a cost-performance analysis. Evaluation of 9 frontier LLMs, using the 35 benchmarks, revealed significant performance variation. Advanced reasoning models (DeepSeek R1: 66% win-rate; o3-mini: 64% win-rate) demonstrated superior performance, though Claude 3.5 Sonnet achieved comparable results at 40% lower estimated computational cost. On a normalized accuracy scale (0-1), most models performed strongly in Clinical Note Generation (0.73-0.85) and Patient Communication & Education (0.78-0.83), moderately in Medical Research Assistance (0.65-0.75), and generally lower in Clinical Decision Support (0.56-0.72) and Administration & Workflow (0.53-0.63). Our LLM-jury evaluation method achieved good agreement with clinician ratings (ICC = 0.47), surpassing both average clinician-clinician agreement (ICC = 0.43) and automated baselines including ROUGE-L (0.36) and BERTScore-F1 (0.44). Claude 3.5 Sonnet achieved comparable performance to top models at lower estimated cost. These findings highlight the importance of real-world, task-specific evaluation for medical use of LLMs and provides an open source framework to enable this.

cs.CL↗

arXiv2025

Creating General User Models from Computer Use

Human-computer interaction has long imagined technology that understands us-from our preferences and habits, to the timing and purpose of our everyday actions. Yet current user models remain fragmented, narrowly tailored to specific apps, and incapable of the flexible reasoning required to fulfill these visions. This paper presents an architecture for a general user model (GUM) that learns about you by observing any interaction you have with your computer. The GUM takes as input any unstructured observation of a user (e.g., device screenshots) and constructs confidence-weighted propositions that capture user knowledge and preferences. GUMs can infer that a user is preparing for a wedding they're attending from messages with a friend. Or recognize that a user is struggling with a collaborator's feedback on a draft by observing multiple stalled edits and a switch to reading related work. GUMs introduce an architecture that infers new propositions about a user from multimodal observations, retrieves related propositions for context, and continuously revises existing propositions. To illustrate the breadth of applications that GUMs enable, we demonstrate how they augment chat-based assistants with context, manage OS notifications to selectively surface important information, and enable interactive agents that adapt to preferences across apps. We also instantiate proactive assistants (GUMBOs) that discover and execute useful suggestions on a user's behalf using their GUM. In our evaluations, we find that GUMs make calibrated and accurate inferences about users, and that assistants built on GUMs proactively identify and perform actions that users wouldn't think to request explicitly. Altogether, GUMs introduce methods that leverage multimodal models to understand unstructured context, enabling long-standing visions of HCI and entirely new interactive systems that anticipate user needs.

cs.HC↗