arXiv subjects

Jimeng Sun

Publications and source records attributed to Jimeng Sun.

At least 19 recordsLinked to original sources

arXiv2026

Towards AI-Assisted Clinical Trial Matching: Practical Considerations, Multicenter Evaluation, and Real-World Deployment

Clinical trials are essential for advancing cancer care and drug development, but many fail because of insufficient patient enrollment. While there is growing interest in using AI to support patient recruitment, existing systems largely perform eligibility assessment alone and have rarely been evaluated in real-world oncology workflows. Here we present TrialGPT 2.0, an AI-assisted clinical trial recommendation system designed for real-world deployment. Rather than asking only whether a patient may qualify, the system also assesses which trials warrant further consideration given the patient's current clinical needs and local workflow priorities, and provides structured, inspectable explanations for expert review. Importantly, we evaluated TrialGPT 2.0 retrospectively and prospectively across multiple oncology-focused settings, spanning government, academic cancer-center, patient-advocacy, and NIH referral workflows. In retrospective multicenter cohorts comprising 288 cases, TrialGPT 2.0 retrieved at least one clinician-recommended trial in its top 10 recommendations for approximately 91% of cases while reducing clinician screening time by 55.0%. In a six-month prospective evaluation embedded in an active precision oncology tumor board, TrialGPT 2.0 contributed additional trial opportunities missed by the routine workflow, expanding patient access to clinical trial participation by 90.9%. To support scientific reproducibility, we also introduce NIH-TrialBench, a clinician-authored dataset comprising 126 diverse synthetic patient vignettes and matching scenarios from 11 NIH Institutes and Centers. Together, these results support the value of AI to assist clinical trial matching by improving clinician efficiency and identifying frequently overlooked trial opportunities, ultimately helping to expand and accelerate accrual to cancer trials.

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arXiv2026

KMGen: A Skill-based Approach for Synthetic Individual Patient Data Generation

Individual patient data (IPD) from clinical trials is the substrate for survival modeling, meta-analysis, and safety research, yet IPD is rarely released. Prior work has addressed only half of this gap: reconstructing Kaplan-Meier (KM) curves from published plots -- typically requiring manual digitization or human-in-the-loop correction -- while offering no mechanism for generating the adverse-event (AE) streams that constitute the other half of a patient record. We introduce KMGen, the first end-to-end framework that (i) fully automates KM curve extraction at accuracy competitive with human-guided tools, and (ii) generates synthetic per-patient AE trajectories from public trial registry records. The extraction stage is a fully automated agentic pipeline -- an agent generates code to extract each step in the KM curve -- achieving a mean Integrated Absolute Error (IAE) of 0.0151 on a 32-plot benchmark spanning clean, edge-case, and adversarial conditions. The IPD generation stage decouples patient archetype extraction from statistical sampling: an LLM distills the trial record into arm-specific statistics, adverse events, patient demographics, and risk multipliers. A mechanistic sampler generates patient events via clinical archetypes, bootstrap rank-correlation coupling to the empirical KM curve (preserving the marginal survival distribution exactly), and cycle-based AE scheduling with an induction/maintenance split. Across three held-out oncology trials spanning an order of magnitude in cohort size and 30 independent regenerations per trial, KMGen achieves mean integrated KM absolute difference $\Delta_{\text{KM}}\,{\leq}\,0.051$, sex/ECOG JSD ${\leq}\,0.013$ on 5 of 6 demographic slots, and recovers ${\geq}\,71\%$ of the top-15 AEs by exact MedDRA term under a single fixed parameter set. The pipeline is released as open source at https://github.com/chufangao/kmgen.

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arXiv2026

Accelerating Reproducible Research in Synthetic EHR Generation

The generation of high-fidelity synthetic Electronic Health Records (EHR) is crucial for advancing medical research while preserving patient privacy. However, head-to-head comparison of existing generative models is hindered by disjointed codebases, incompatible data loaders, conflicting library dependencies, and inconsistent evaluation protocols. To address these gaps, we introduce a lightweight, end-to-end benchmarking framework for reproducible synthetic EHR evaluation, organized as a unified pipeline spanning data ingestion, standardized model training, and architecture-agnostic evaluation. Our current implementation targets the generation of longitudinal ICD diagnosis codes -- the most commonly studied modality in this literature -- and is built on the community-maintained PyHealth library. We reimplement and unify strong baselines (MedGAN, CorGAN, PromptEHR, HALO) under full ICD-9 vocabulary granularity, and add a lightweight GPT-2 baseline from the general-purpose sequence-modeling literature. We contribute a rigorous, architecture-agnostic privacy-utility evaluation suite that applies identically to GAN- and transformer-based generators, and report bootstrapped confidence intervals across all metrics. We further analyze the poor long-tailed performance of existing models and discuss the extensibility of our framework beyond diagnosis codes. By lowering the engineering barrier to running, extending, and evaluating under a single pipeline, we introduce a starting point for community-driven reproducibility and benchmarking synthetic EHR models.

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arXiv2026

Harness-1: Reinforcement Learning for Search Agents with State-Externalizing Harnesses

Search agents are often trained as policies over growing transcripts: the model must decide how to search while also remembering what it has seen, which evidence is useful, which constraints remain open, and which claims have actually been checked. We argue that this formulation puts too much routine state management inside the policy: reinforcement learning is forced to optimize both semantic search decisions and recoverable bookkeeping that the environment can maintain more reliably. We introduce Harness-1, a 20B search agent (retrieval subagent) trained with reinforcement learning inside a stateful search harness. The harness maintains environment-side working memory, including a candidate pool, an importance-tagged curated set, compact evidence links, verification records, compressed and deduplicated observations, and budget-aware context rendering. The policy retains the semantic decisions: what to search, which documents to keep or discard, what to verify, and when to stop. Across eight retrieval benchmarks spanning web, finance, patents, and multi-hop QA, Harness-1 achieves 0.730 average curated recall, outperforming the next strongest open search subagent by +11.4 points and remaining competitive with much larger frontier-model searchers. Its gains are especially strong on held-out transfer benchmarks, suggesting that reinforcement learning over explicit search state can produce retrieval behaviors that generalize beyond the training domains. Our code is available at https://github.com/pat-jj/harness-1.

cs.AI↗

arXiv2026

Graph Alignment Topology as an Inductive Bias for Grounding Detection

Large Language Models (LLMs) are optimized to produce distributionally plausible continuations rather than to explicitly verify whether generated propositions are entailed by source documents. This inductive bias enables generalization, but it does not encode whether responses are grounded with respect to a reference. These issues limit the use of LLMs in domains where strict factual correctness is crucial, such as clinical decision support. Existing hallucination detection approaches improve factuality through retrieval augmentation, self-consistency, or claim verification, but generally do not learn directly over alignment topology. To leverage alignment topology as an inductive bias, we construct aligned bipartite graphs between reference information and LLM outputs and train a graph neural network (GNN) to model alignment structure using message passing. The method achieves state-of-the-art results on four diverse hallucination and question-answering datasets, outperforming all compared methods, including foundational LLMs such as GPT-4o.

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arXiv2026

EpiGraph: Building Generalists for Evidence-Intensive Epilepsy Reasoning in the Wild

Epilepsy diagnosis and treatment require evidence-intensive reasoning across heterogeneous clinical knowledge, including biosignal patterns, genetic mechanisms, pharmacogenomics, treatment strategies, and patient outcomes. In this work, we present \textsc{EpiGraph}, a large-scale epilepsy knowledge graph and benchmark for evaluating knowledge-augmented clinical reasoning. \textsc{EpiGraph} integrates 48,166 peer-reviewed papers and seven clinical resources into a heterogeneous graph containing 24,324 entities and 32,009 evidence-grounded triplets across five clinical layers. Built upon this graph, \textsc{EpiBench} defines five clinically motivated tasks spanning clinical decision-making, EEG report generation, pharmacogenomic precision medicine, treatment recommendation, and deep research planning. We evaluate six LLMs under both standard and Graph-RAG settings. Results show that integrating \textsc{EpiGraph} consistently improves performance across all tasks, with the largest gains observed in pharmacogenomic reasoning (+30--41\%). Our findings demonstrate that structured epilepsy knowledge substantially enhances evidence-grounded clinical reasoning and provides a practical benchmark framework for evaluating knowledge-augmented LLMs in real-world neurological settings. Our code is available at: https://github.com/LabRAI/EEG-KG.

cs.AI↗

arXiv2026

Test-Time Adaptation for EEG Foundation Models: A Systematic Study under Real-World Distribution Shifts

Electroencephalography (EEG) foundation models have shown strong potential for learning generalizable representations from large-scale neural data, yet their clinical deployment is hindered by distribution shifts across clinical settings, devices, and populations. Test-time adaptation (TTA) offers a promising solution by enabling models to adapt to unlabeled target data during inference without access to source data, a valuable property in healthcare settings constrained by privacy regulations and limited labeled data. However, its effectiveness for EEG remains largely underexplored. In this work, we introduce NeuroAdapt-Bench, a systematic benchmark for evaluating test-time adaptation methods on EEG foundation models under realistic distribution shifts. We evaluate representative TTA approaches from other domains across multiple pretrained foundation models, diverse downstream tasks, and heterogeneous datasets spanning in-distribution, out-of-distribution, and extreme modality shifts (e.g., Ear-EEG). Our results show that the evaluated TTA methods yield inconsistent gains and often degrade performance, with gradient-based approaches particularly prone to heavy degradation and optimization-free methods showing greater stability. For the evaluated EEG foundation models and representative TTA methods, these findings highlight the limitations of directly applying existing TTA techniques to EEG and underscore the need for domain-specific adaptation strategies.

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arXiv2026

KMM-CP: Practical Conformal Prediction under Covariate Shift via Selective Kernel Mean Matching

Uncertainty quantification is essential for deploying machine learning models in high-stakes domains such as scientific discovery and healthcare. Conformal Prediction (CP) provides finite-sample coverage guarantees under exchangeability, an assumption often violated in practice due to distribution shift. Under covariate shift, restoring validity requires importance weighting, yet accurate density-ratio estimation becomes unstable when training and test distributions exhibit limited support overlap. We propose KMM-CP, a conformal prediction framework based on Kernel Mean Matching (KMM) for covariate-shift correction. We show that KMM directly controls the bias-variance components governing conformal coverage error by minimizing RKHS moment discrepancy under explicit weight constraints, and establish asymptotic coverage guarantees under mild conditions. We then introduce a selective extension that identifies regions of reliable support overlap and restricts conformal correction to this subset, further improving stability in low-overlap regimes. Experiments on molecular property prediction benchmarks with realistic distribution shifts show that KMM-CP reduces coverage gap by over 50% compared to existing approaches. The code is available at https://github.com/siddharthal/KMM-CP.

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arXiv2026

A Practical Guide Towards Interpreting Time-Series Deep Clinical Predictive Models: A Reproducibility Study

Clinical decisions are high-stakes and require explicit justification, making model interpretability essential for auditing deep clinical models prior to deployment. As the ecosystem of model architectures and explainability methods expands, critical questions remain: Do architectural features like attention improve explainability? Do interpretability approaches generalize across clinical tasks? While prior benchmarking efforts exist, they often lack extensibility and reproducibility, and critically, fail to systematically examine how interpretability varies across the interplay of clinical tasks and model architectures. To address these gaps, we present a comprehensive benchmark evaluating interpretability methods across diverse clinical prediction tasks and model architectures. Our analysis reveals that: (1) attention when leveraged properly is a highly efficient approach for faithfully interpreting model predictions; (2) black-box interpreters like KernelSHAP and LIME are computationally infeasible for time-series clinical prediction tasks; and (3) several interpretability approaches are too unreliable to be trustworthy. From our findings, we discuss several guidelines on improving interpretability within clinical predictive pipelines. To support reproducibility and extensibility, we provide our implementations via PyHealth, a well-documented open-source framework: https://github.com/sunlabuiuc/PyHealth.

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arXiv2026

ConfHit: Conformal Generative Design with Oracle Free Guarantees

The success of deep generative models in scientific discovery requires not only the ability to generate novel candidates but also reliable guarantees that these candidates indeed satisfy desired properties. Recent conformal-prediction methods offer a path to such guarantees, but its application to generative modeling in drug discovery is limited by budget constraints, lack of oracle access, and distribution shift. To this end, we introduce ConfHit, a distribution-free framework that provides validity guarantees under these conditions. ConfHit formalizes two central questions: (i) Certification: whether a generated batch can be guaranteed to contain at least one hit with a user-specified confidence level, and (ii) Design: whether the generation can be refined to a compact set without weakening this guarantee. ConfHit leverages weighted exchangeability between historical and generated samples to eliminate the need for an experimental oracle, constructs multiple-sample density-ratio weighted conformal p-value to quantify statistical confidence in hits, and proposes a nested testing procedure to certify and refine candidate sets of multiple generated samples while maintaining statistical guarantees. Across representative generative molecule design tasks and a broad range of methods, ConfHit consistently delivers valid coverage guarantees at multiple confidence levels while maintaining compact certified sets, establishing a principled and reliable framework for generative modeling.

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arXiv2026

Bridging the Reproducibility Divide: Open Source Software's Role in Standardizing Healthcare AI

Our analysis of recent AI4H publications reveals that, despite a trend toward utilizing open datasets and sharing modeling code, 74% of AI4H papers still rely on private datasets or do not share their code. This is especially concerning in healthcare applications, where trust is essential. Furthermore, inconsistent and poorly documented data preprocessing pipelines result in variable model performance reports, even for identical tasks and datasets, making it challenging to evaluate the true effectiveness of AI models. Despite the challenges posed by the reproducibility crisis, addressing these issues through open practices offers substantial benefits. For instance, while the reproducibility mandate adds extra effort to research and publication, it significantly enhances the impact of the work. Our analysis shows that papers that used both public datasets and shared code received, on average, 110% more citations than those that do neither--more than doubling the citation count. Given the clear benefits of enhancing reproducibility, it is imperative for the AI4H community to take concrete steps to overcome existing barriers. The community should promote open science practices, establish standardized guidelines for data preprocessing, and develop robust benchmarks. Tackling these challenges through open-source development can improve reproducibility, which is essential for ensuring that AI models are safe, effective, and beneficial for patient care. This approach will help build more trustworthy AI systems that can be integrated into healthcare settings, ultimately contributing to better patient outcomes and advancing the field of medicine.

cs.CY↗

arXiv2026

How Well Do Multimodal Models Reason on ECG Signals?

While multimodal large language models offer a promising solution to the "black box" nature of health AI by generating interpretable reasoning traces, verifying the validity of these traces remains a critical challenge. Existing evaluation methods are either unscalable, relying on manual clinician review, or superficial, utilizing proxy metrics (e.g. QA) that fail to capture the semantic correctness of clinical logic. In this work, we introduce a reproducible framework for evaluating reasoning in ECG signals. We propose decomposing reasoning into two distinct, components: (i) Perception, the accurate identification of patterns within the raw signal, and (ii) Deduction, the logical application of domain knowledge to those patterns. To evaluate Perception, we employ an agentic framework that generates code to empirically verify the temporal structures described in the reasoning trace. To evaluate Deduction, we measure the alignment of the model's logic against a structured database of established clinical criteria in a retrieval-based approach. This dual-verification method enables the scalable assessment of "true" reasoning capabilities.

cs.AI↗

arXiv2026

ODEBrain: Continuous-Time EEG Graph for Modeling Dynamic Brain Networks

Modeling neural population dynamics is crucial for foundational neuroscientific research and various clinical applications. Conventional latent variable methods typically model continuous brain dynamics through discretizing time with recurrent architecture, which necessarily results in compounded cumulative prediction errors and failure of capturing instantaneous, nonlinear characteristics of EEGs. We propose ODEBRAIN, a Neural ODE latent dynamic forecasting framework to overcome these challenges by integrating spatio-temporal-frequency features into spectral graph nodes, followed by a Neural ODE modeling the continuous latent dynamics. Our design ensures that latent representations can capture stochastic variations of complex brain states at any given time point. Extensive experiments verify that ODEBRAIN can improve significantly over existing methods in forecasting EEG dynamics with enhanced robustness and generalization capabilities.

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arXiv2026

Making Conformal Predictors Robust in Healthcare Settings: a Case Study on EEG Classification

Quantifying uncertainty in clinical predictions is critical for high-stakes diagnosis tasks. Conformal prediction offers a principled approach by providing prediction sets with theoretical coverage guarantees. However, in practice, patient distribution shifts violate the i.i.d. assumptions underlying standard conformal methods, leading to poor coverage in healthcare settings. In this work, we evaluate several conformal prediction approaches on EEG seizure classification, a task with known distribution shift challenges and label uncertainty. We demonstrate that personalized calibration strategies can improve coverage by over 20 percentage points while maintaining comparable prediction set sizes. Our implementation is available via PyHealth, an open-source healthcare AI framework: https://github.com/sunlabuiuc/PyHealth.

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arXiv2026

AdNanny: One Reasoning LLM for All Offline Ads Recommendation Tasks

Large Language Models (LLMs) have shown strong capabilities in Natural Language Understanding and Generation, but deploying them directly in online advertising systems is often impractical due to strict millisecond-level latency constraints. This has motivated the use of LLMs offline to improve retrieval, ranking, and recommendation models. Existing solutions typically fine-tune separate LLMs for individual tasks such as query-ad relevance labeling, keyword-based query generation, and user profiling. This results in redundant models, high maintenance cost, and limited performance gains despite substantial overlap in domain knowledge and reasoning patterns. We introduce AdNanny, a unified reasoning-centric LLM that serves as a shared backbone for offline advertising tasks. AdNanny is obtained by fine-tuning a public 671B-parameter DeepSeek-R1 checkpoint using a scalable training system that supports hybrid dense-MoE parallelism. We construct reasoning-augmented corpora that pair structured supervision with step-by-step natural language explanations. A multi-task supervised fine-tuning stage with adaptive reweighting enables AdNanny to handle diverse labeling and generation tasks in a consistent reasoning format. This is followed by reinforcement learning using downstream advertising metrics to align model behavior with online retrieval and ranking objectives. AdNanny is deployed in production within Bing Ads, where it significantly reduces manual labeling effort and improves accuracy across multiple offline tasks. By consolidating many task-specific models into a single reasoning-centric foundation model, AdNanny provides a scalable and cost-effective solution for large-scale advertising systems.

cs.SE↗

arXiv2026

Neural Signals Generate Clinical Notes in the Wild

Generating clinical reports that summarize abnormal patterns, diagnostic findings, and clinical interpretations from long-term EEG recordings remains labor-intensive. We present CELM, the first clinical EEG-to-Language foundation model capable of summarizing long-duration, variable-length EEG recordings and performing end-to-end clinical report generation at multiple scales. CELM integrates pretrained EEG foundation models with language models to enable scalable multimodal learning. We curate a large-scale clinical EEG dataset containing 9,922 reports paired with approximately 11,000 hours of EEG recordings from 9,048 patients to train CELM, and release the benchmark with an automated report-structuring pipeline to facilitate future research. Experimental results show that CELM consistently outperforms existing methods across all evaluation settings. Importantly, we further conduct human evaluation with clinical experts, demonstrating that CELM generates reports that are more clinically coherent, diagnostically reliable, and better aligned with expert interpretation. We release our model and benchmark construction pipeline at https://github.com/Jathurshan0330/CELM.

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arXiv2026

PyHealth 2.0: A Comprehensive Open-Source Toolkit for Accessible and Reproducible Clinical Deep Learning

Difficulty replicating baselines, high computational costs, and required domain expertise create persistent barriers to clinical AI research. To address these challenges, we introduce PyHealth 2.0, an enhanced clinical deep learning toolkit that enables predictive modeling in as few as 7 lines of code. PyHealth 2.0 offers three key contributions: (1) a comprehensive toolkit addressing reproducibility and compatibility challenges by unifying 15+ datasets, 20+ clinical tasks, 25+ models, 5+ interpretability methods, and uncertainty quantification including conformal prediction within a single framework that supports diverse clinical data modalities - signals, imaging, and electronic health records - with translation of 5+ medical coding standards; (2) accessibility-focused design accommodating multimodal data and diverse computational resources with up to 39x faster processing and 20x lower memory usage, enabling work from 16GB laptops to production systems; and (3) an active open-source community of 400+ members lowering domain expertise barriers through extensive documentation, reproducible research contributions, and collaborations with academic health systems and industry partners, including multi-language support via RHealth. PyHealth 2.0 establishes an open-source foundation and community advancing accessible, reproducible healthcare AI. Available at pip install pyhealth.

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arXiv2026

$\texttt{AMEND++}$: Benchmarking Eligibility Criteria Amendments in Clinical Trials

Clinical trial amendments frequently introduce delays, increased costs, and administrative burden, with eligibility criteria being the most commonly amended component. We introduce \textit{eligibility criteria amendment prediction}, a novel NLP task that aims to forecast whether the eligibility criteria of an initial trial protocol will undergo future amendments. To support this task, we release $\texttt{AMEND++}$, a benchmark suite comprising two datasets: $\texttt{AMEND}$, which captures eligibility-criteria version histories and amendment labels from public clinical trials, and $\verb|AMEND_LLM|$, a refined subset curated using an LLM-based denoising pipeline to isolate substantive changes. We further propose $\textit{Change-Aware Masked Language Modeling}$ (CAMLM), a revision-aware pretraining strategy that leverages historical edits to learn amendment-sensitive representations. Experiments across diverse baselines show that CAMLM consistently improves amendment prediction, enabling more robust and cost-effective clinical trial design.

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