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Jinge Wu

Publications and source records attributed to Jinge Wu.

At least 19 recordsLinked to original sources

Measuring Epistemic Resilience of LLMs Under Misleading Medical Context

Large language models (LLMs) now reach expert-level scores on medical licensing exams, encouraging the assumption that high scores imply safe medical judgment while patients increasingly use them for health advice. We show this assumption is fragile: when misleading context is injected into questions that LLMs originally answer correctly, they abandon the correct answer. We call the ability to maintain correct judgment under adversarial context epistemic resilience, and introduce MedMisBench to measure it. MedMisBench contains 10,932 medical question items and 48,889 misleading context-option pairs spanning medical reasoning, agentic capability, and patient-journey evaluation. Across 11 model configurations, mean accuracy falls from 71.1% on original questions to 38.0% under focused misleading context, with 51.5% attack success. The most damaging injections are formal, rule-like fabrications: authority-framed falsehoods reach 69.5% attack success and exception-poisoning claims reach 64.1%. A 14-member clinical panel from 7 countries identified serious potential harm in 38.2% of reviewed cases. MedMisBench exposes a structural blind spot in LLM evaluation in medical settings: existing benchmarks measure what models know, but not whether they preserve correct medical judgment under misleading context.

cs.CL

BioMedArena: An Open-source Toolkit for Building and Evaluating Biomedical Deep Research Agents

Reproducing and comparing deep research agents today is hard: the same backbone evaluated on the same benchmark can report different accuracies across papers because the harness and tool registry differ, and integrating a new model into a comparable evaluation surface costs weeks of model-specific engineering. These are symptoms of a broader reproducibility problem in deep research agent research. Here, we introduce BioMedArena, an open-source toolkit that addresses this reproducibility gap and provides an arena for comparing deep research agents under a shared evaluation environment. BioMedArena decouples six layers of biomedical agent evaluation -- benchmark loading, tool exposure, tool selection, harness mode, context management, and scoring -- and exposes 166 biomedical benchmarks and 75 biomedical tools across 9 functional families. Adding a new model, benchmark, or tool can be accomplished with a few-line provider adapter. Beyond evaluation infrastructure, BioMedArena ships a library of high-quality reference components: 6 agent harnesses (including our proposed Mutual-Evolve) and 6 context-management strategies, any of which can be equipped on any backbone. Equipping these components substantially improves all 12 backbones; on each of 8 representative biomedical benchmarks, the best equipped backbone surpasses prior state-of-the-art (SOTA), by 15.01 percentage points on average. The toolkit, configurations, and per-task traces are available at https://github.com/AI-in-Health/BioMedArena.

cs.AI

Clinical-R1: Empowering Large Language Models for Faithful and Comprehensive Reasoning with Clinical Objective Relative Policy Optimization

Recent advances in large language models (LLMs) have shown strong reasoning capabilities through large-scale pretraining and post-training reinforcement learning, demonstrated by DeepSeek-R1. However, current post-training methods, such as Grouped Relative Policy Optimization (GRPO), mainly reward correctness, which is not aligned with the multi-dimensional objectives required in high-stakes fields such as medicine, where reasoning must also be faithful and comprehensive. We introduce Clinical-Objective Relative Policy Optimization (CRPO), a scalable, multi-objective, verifiable reinforcement learning method designed to align LLM post-training with clinical reasoning principles. CRPO integrates rule-based and verifiable reward signals that jointly optimize accuracy, faithfulness, and comprehensiveness without relying on human annotation. To demonstrate its effectiveness, we train Clinical-R1-3B, a 3B-parameter model for clinical reasoning. The experiments on three benchmarks demonstrate that our CRPO substantially improves reasoning on truthfulness and completeness over standard GRPO while maintaining comfortable accuracy enhancements. This framework provides a scalable pathway to align LLM reasoning with clinical objectives, enabling safer and more collaborative AI systems for healthcare while also highlighting the potential of multi-objective, verifiable RL methods in post-training scaling of LLMs for medical domains.

cs.AI

Graph-based LLM over Semi-Structured Population Data for Dynamic Policy Response

Timely and accurate analysis of population-level data is crucial for effective decision-making during public health emergencies such as the COVID-19 pandemic. However, the massive input of semi-structured data, including structured demographic information and unstructured human feedback, poses significant challenges to conventional analysis methods. Manual expert-driven assessments, though accurate, are inefficient, while standard NLP pipelines often require large task-specific labeled datasets and struggle with generalization across diverse domains. To address these challenges, we propose a novel graph-based reasoning framework that integrates large language models with structured demographic attributes and unstructured public feedback in a weakly supervised pipeline. The proposed approach dynamically models evolving citizen needs into a need-aware graph, enabling population-specific analyses based on key features such as age, gender, and the Index of Multiple Deprivation. It generates interpretable insights to inform responsive health policy decision-making. We test our method using a real-world dataset, and preliminary experimental results demonstrate its feasibility. This approach offers a scalable solution for intelligent population health monitoring in resource-constrained clinical and governmental settings.

cs.AI

RadEyeVideo: Enhancing general-domain Large Vision Language Model for chest X-ray analysis with video representations of eye gaze

Large Vision-Language Models (LVLMs) have demonstrated promising performance in chest X-ray (CXR) analysis. To enhance human-computer interaction, several studies have incorporated radiologists' eye gaze, typically through heatmaps or textual prompts. However, these methods often overlook the sequential order of eye movements, which could provide valuable insights by highlighting both the areas of interest and the order in which they are examined. In this work, we propose a novel approach called RadEyeVideo that integrates radiologists' eye-fixation data as a video sequence, capturing both the temporal and spatial dynamics of their gaze. We evaluate this method in CXR report generation and disease diagnosis using three general-domain, open-source LVLMs with video input capabilities. When prompted with eye-gaze videos, model performance improves by up to 24.6% in the report generation task and on average 15.2% for both tasks using scaled evaluation metrics. Notably, RadEyeVideo enhanced an open-domain LVLM model, LLaVA-OneVision, to surpass task-specific medical LVLMs such as MAIRA-2 and CheXagent, trained on large Chest X-ray data. This work highlights that domain expert's knowledge (eye-gaze information in this case), when effectively integrated with LVLMs, can significantly enhance general-domain models' capabilities in clinical tasks. RadEyeVideo is a step toward a scalable human-centered approach of utilizing LVLMs in medical image analytics.

cs.CV

Look & Mark: Leveraging Radiologist Eye Fixations and Bounding boxes in Multimodal Large Language Models for Chest X-ray Report Generation

Recent advancements in multimodal Large Language Models (LLMs) have significantly enhanced the automation of medical image analysis, particularly in generating radiology reports from chest X-rays (CXR). However, these models still suffer from hallucinations and clinically significant errors, limiting their reliability in real-world applications. In this study, we propose Look & Mark (L&M), a novel grounding fixation strategy that integrates radiologist eye fixations (Look) and bounding box annotations (Mark) into the LLM prompting framework. Unlike conventional fine-tuning, L&M leverages in-context learning to achieve substantial performance gains without retraining. When evaluated across multiple domain-specific and general-purpose models, L&M demonstrates significant gains, including a 1.2% improvement in overall metrics (A.AVG) for CXR-LLaVA compared to baseline prompting and a remarkable 9.2% boost for LLaVA-Med. General-purpose models also benefit from L&M combined with in-context learning, with LLaVA-OV achieving an 87.3% clinical average performance (C.AVG)-the highest among all models, even surpassing those explicitly trained for CXR report generation. Expert evaluations further confirm that L&M reduces clinically significant errors (by 0.43 average errors per report), such as false predictions and omissions, enhancing both accuracy and reliability. These findings highlight L&M's potential as a scalable and efficient solution for AI-assisted radiology, paving the way for improved diagnostic workflows in low-resource clinical settings.

cs.CV

Towards deployment-centric multimodal AI beyond vision and language

Multimodal artificial intelligence (AI) integrates diverse types of data via machine learning to improve understanding, prediction, and decision-making across disciplines such as healthcare, science, and engineering. However, most multimodal AI advances focus on models for vision and language data, while their deployability remains a key challenge. We advocate a deployment-centric workflow that incorporates deployment constraints early to reduce the likelihood of undeployable solutions, complementing data-centric and model-centric approaches. We also emphasise deeper integration across multiple levels of multimodality and multidisciplinary collaboration to significantly broaden the research scope beyond vision and language. To facilitate this approach, we identify common multimodal-AI-specific challenges shared across disciplines and examine three real-world use cases: pandemic response, self-driving car design, and climate change adaptation, drawing expertise from healthcare, social science, engineering, science, sustainability, and finance. By fostering multidisciplinary dialogue and open research practices, our community can accelerate deployment-centric development for broad societal impact.

cs.AI

Minuscule Cell Detection in AS-OCT Images with Progressive Field-of-View Focusing

Anterior Segment Optical Coherence Tomography (AS-OCT) is an emerging imaging technique with great potential for diagnosing anterior uveitis, a vision-threatening ocular inflammatory condition. A hallmark of this condition is the presence of inflammatory cells in the eye's anterior chamber, and detecting these cells using AS-OCT images has attracted research interest. While recent efforts aim to replace manual cell detection with automated computer vision approaches, detecting extremely small (minuscule) objects in high-resolution images, such as AS-OCT, poses substantial challenges: (1) each cell appears as a minuscule particle, representing less than 0.005\% of the image, making the detection difficult, and (2) OCT imaging introduces pixel-level noise that can be mistaken for cells, leading to false positive detections. To overcome these challenges, we propose a minuscule cell detection framework through a progressive field-of-view focusing strategy. This strategy systematically refines the detection scope from the whole image to a target region where cells are likely to be present, and further to minuscule regions potentially containing individual cells. Our framework consists of two modules. First, a Field-of-Focus module uses a vision foundation model to segment the target region. Subsequently, a Fine-grained Object Detection module introduces a specialized Minuscule Region Proposal followed by a Spatial Attention Network to distinguish individual cells from noise within the segmented region. Experimental results demonstrate that our framework outperforms state-of-the-art methods for cell detection, providing enhanced efficacy for clinical applications. Our code is publicly available at: https://github.com/joeybyc/MCD.

cs.CV

RiskAgent: Synergizing Language Models with Validated Tools for Evidence-Based Risk Prediction

Large Language Models (LLMs) achieve competitive results compared to human experts in medical examinations. However, it remains a challenge to apply LLMs to complex clinical decision-making, which requires a deep understanding of medical knowledge and differs from the standardized, exam-style scenarios commonly used in current efforts. A common approach is to fine-tune LLMs for target tasks, which, however, not only requires substantial data and computational resources but also remains prone to generating `hallucinations'. In this work, we present RiskAgent, which synergizes language models with hundreds of validated clinical decision tools supported by evidence-based medicine, to provide generalizable and faithful recommendations. Our experiments show that RiskAgent not only achieves superior performance on a broad range of clinical risk predictions across diverse scenarios and diseases, but also demonstrates robust generalization in tool learning on the external MedCalc-Bench dataset, as well as in medical reasoning and question answering on three representative benchmarks, MedQA, MedMCQA, and MMLU.

cs.LG

SLaVA-CXR: Small Language and Vision Assistant for Chest X-ray Report Automation

Inspired by the success of large language models (LLMs), there is growing research interest in developing LLMs in the medical domain to assist clinicians. However, for hospitals, using closed-source commercial LLMs involves privacy issues, and developing open-source public LLMs requires large-scale computational resources, which are usually limited, especially in resource-efficient regions and low-income countries. We propose an open-source Small Language and Vision Assistant (SLaVA-CXR) that can be used for Chest X-Ray report automation. To efficiently train a small assistant, we first propose the Re$^3$Training method, which simulates the cognitive development of radiologists and optimizes the model in the Recognition, Reasoning, and Reporting training manner. Then, we introduce a data synthesis method, RADEX, which can generate a high-quality and diverse training corpus with privacy regulation compliance. The extensive experiments show that our SLaVA-CXR built on a 2.7B backbone not only outperforms but also achieves 6 times faster inference efficiency than previous state-of-the-art larger models.

cs.LG

Error Correction in Radiology Reports: A Knowledge Distillation-Based Multi-Stage Framework

The increasing complexity and workload of clinical radiology leads to inevitable oversights and mistakes in their use as diagnostic tools, causing delayed treatments and sometimes life-threatening harm to patients. While large language models (LLMs) have shown remarkable progress in many tasks, their utilities in detecting and correcting errors in radiology reporting are limited. This paper proposes a novel dual-knowledge infusion framework that enhances LLMs' capability for radiology report proofreading through systematic integration of medical expertise. Specifically, the knowledge infusion combines medical knowledge graph distillation (MKGD) with external knowledge retrieval (EXKR), enabling an effective automated approach in tackling mistakes in radiology reporting. By decomposing the complex proofreading task into three specialized stages of detection, localization, and correction, our method mirrors the systematic review process employed by expert radiologists, ensuring both precision and clinical interpretability. To perform a robust, clinically relevant evaluation, a comprehensive benchmark is also proposed using real-world radiology reports with real-world error patterns, including speech recognition confusions, terminology ambiguities, and template-related inconsistencies. Extensive evaluations across multiple LLM architectures demonstrate substantial improvements of our approach: up to 31.56% increase in error detection accuracy and 37.4% reduction in processing time. Human evaluation by radiologists confirms superior clinical relevance and factual consistency compared to existing approaches.

cs.CL

Infusing clinical knowledge into tokenisers for language models

This study introduces a novel knowledge enhanced tokenisation mechanism, K-Tokeniser, for clinical text processing. Technically, at initialisation stage, K-Tokeniser populates global representations of tokens based on semantic types of domain concepts (such as drugs or diseases) from either a domain ontology like Unified Medical Language System or the training data of the task related corpus. At training or inference stage, sentence level localised context will be utilised for choosing the optimal global token representation to realise the semantic-based tokenisation. To avoid pretraining using the new tokeniser, an embedding initialisation approach is proposed to generate representations for new tokens. Using three transformer-based language models, a comprehensive set of experiments are conducted on four real-world datasets for evaluating K-Tokeniser in a wide range of clinical text analytics tasks including clinical concept and relation extraction, automated clinical coding, clinical phenotype identification, and clinical research article classification. Overall, our models demonstrate consistent improvements over their counterparts in all tasks. In particular, substantial improvements are observed in the automated clinical coding task with 13\% increase on Micro $F_1$ score. Furthermore, K-Tokeniser also shows significant capacities in facilitating quicker converge of language models. Specifically, using K-Tokeniser, the language models would only require 50\% of the training data to achieve the best performance of the baseline tokeniser using all training data in the concept extraction task and less than 20\% of the data for the automated coding task. It is worth mentioning that all these improvements require no pre-training process, making the approach generalisable.

cs.CL

Chain-of-Though (CoT) prompting strategies for medical error detection and correction

This paper describes our submission to the MEDIQA-CORR 2024 shared task for automatically detecting and correcting medical errors in clinical notes. We report results for three methods of few-shot In-Context Learning (ICL) augmented with Chain-of-Thought (CoT) and reason prompts using a large language model (LLM). In the first method, we manually analyse a subset of train and validation dataset to infer three CoT prompts by examining error types in the clinical notes. In the second method, we utilise the training dataset to prompt the LLM to deduce reasons about their correctness or incorrectness. The constructed CoTs and reasons are then augmented with ICL examples to solve the tasks of error detection, span identification, and error correction. Finally, we combine the two methods using a rule-based ensemble method. Across the three sub-tasks, our ensemble method achieves a ranking of 3rd for both sub-task 1 and 2, while securing 7th place in sub-task 3 among all submissions.

cs.CL

MedExQA: Medical Question Answering Benchmark with Multiple Explanations

This paper introduces MedExQA, a novel benchmark in medical question-answering, to evaluate large language models' (LLMs) understanding of medical knowledge through explanations. By constructing datasets across five distinct medical specialties that are underrepresented in current datasets and further incorporating multiple explanations for each question-answer pair, we address a major gap in current medical QA benchmarks which is the absence of comprehensive assessments of LLMs' ability to generate nuanced medical explanations. Our work highlights the importance of explainability in medical LLMs, proposes an effective methodology for evaluating models beyond classification accuracy, and sheds light on one specific domain, speech language pathology, where current LLMs including GPT4 lack good understanding. Our results show generation evaluation with multiple explanations aligns better with human assessment, highlighting an opportunity for a more robust automated comprehension assessment for LLMs. To diversify open-source medical LLMs (currently mostly based on Llama2), this work also proposes a new medical model, MedPhi-2, based on Phi-2 (2.7B). The model outperformed medical LLMs based on Llama2-70B in generating explanations, showing its effectiveness in the resource-constrained medical domain. We will share our benchmark datasets and the trained model.

cs.CL

RadBARTsum: Domain Specific Adaption of Denoising Sequence-to-Sequence Models for Abstractive Radiology Report Summarization

Radiology report summarization is a crucial task that can help doctors quickly identify clinically significant findings without the need to review detailed sections of reports. This study proposes RadBARTsum, a domain-specific and ontology facilitated adaptation of the BART model for abstractive radiology report summarization. The approach involves two main steps: 1) re-training the BART model on a large corpus of radiology reports using a novel entity masking strategy to improving biomedical domain knowledge learning, and 2) fine-tuning the model for the summarization task using the Findings and Background sections to predict the Impression section. Experiments are conducted using different masking strategies. Results show that the re-training process with domain knowledge facilitated masking improves performances consistently across various settings. This work contributes a domain-specific generative language model for radiology report summarization and a method for utilising medical knowledge to realise entity masking language model. The proposed approach demonstrates a promising direction of enhancing the efficiency of language models by deepening its understanding of clinical knowledge in radiology reports.

cs.CL

A Hybrid Framework with Large Language Models for Rare Disease Phenotyping

Rare diseases pose significant challenges in diagnosis and treatment due to their low prevalence and heterogeneous clinical presentations. Unstructured clinical notes contain valuable information for identifying rare diseases, but manual curation is time-consuming and prone to subjectivity. This study aims to develop a hybrid approach combining dictionary-based natural language processing (NLP) tools with large language models (LLMs) to improve rare disease identification from unstructured clinical reports. We propose a novel hybrid framework that integrates the Orphanet Rare Disease Ontology (ORDO) and the Unified Medical Language System (UMLS) to create a comprehensive rare disease vocabulary. The proposed hybrid approach demonstrates superior performance compared to traditional NLP systems and standalone LLMs. Notably, the approach uncovers a significant number of potential rare disease cases not documented in structured diagnostic records, highlighting its ability to identify previously unrecognized patients.

cs.CL

Enhancing Human-Computer Interaction in Chest X-ray Analysis using Vision and Language Model with Eye Gaze Patterns

Recent advancements in Computer Assisted Diagnosis have shown promising performance in medical imaging tasks, particularly in chest X-ray analysis. However, the interaction between these models and radiologists has been primarily limited to input images. This work proposes a novel approach to enhance human-computer interaction in chest X-ray analysis using Vision-Language Models (VLMs) enhanced with radiologists' attention by incorporating eye gaze data alongside textual prompts. Our approach leverages heatmaps generated from eye gaze data, overlaying them onto medical images to highlight areas of intense radiologist's focus during chest X-ray evaluation. We evaluate this methodology in tasks such as visual question answering, chest X-ray report automation, error detection, and differential diagnosis. Our results demonstrate the inclusion of eye gaze information significantly enhances the accuracy of chest X-ray analysis. Also, the impact of eye gaze on fine-tuning was confirmed as it outperformed other medical VLMs in all tasks except visual question answering. This work marks the potential of leveraging both the VLM's capabilities and the radiologist's domain knowledge to improve the capabilities of AI models in medical imaging, paving a novel way for Computer Assisted Diagnosis with a human-centred AI.

cs.CV

Hallucination Benchmark in Medical Visual Question Answering

The recent success of large language and vision models (LLVMs) on vision question answering (VQA), particularly their applications in medicine (Med-VQA), has shown a great potential of realizing effective visual assistants for healthcare. However, these models are not extensively tested on the hallucination phenomenon in clinical settings. Here, we created a hallucination benchmark of medical images paired with question-answer sets and conducted a comprehensive evaluation of the state-of-the-art models. The study provides an in-depth analysis of current models' limitations and reveals the effectiveness of various prompting strategies.

cs.CL