arXiv subjects

Paul Vozila

Publications and source records attributed to Paul Vozila.

11 recordsLinked to original sources

arXiv2026

SchemaRAG: Dynamic Large Schema Reduction for LLM-driven Structured Information Extraction

Extracting structured data from unstructured text using large language models (LLMs) becomes challenging when target schemas are large and complex. In such cases, including the full schema in the prompt increases cost and latency, risks lost-in-the-middle performance degradation, and can exceed context length limits. We propose SchemaRAG, a retrieval-augmented generation (RAG) framework that dynamically prunes the output schema space for schema-conditioned information extraction tasks by leveraging schema metadata and few-shot examples when available. We evaluate SchemaRAG on real-world healthcare and e-commerce datasets. Our results show that SchemaRAG can achieve up to an 8.8% increase in micro-F1, a 47% reduction in latency, and a 48% reduction in token costs, demonstrating its practicality for large-schema extraction.

cs.IR↗

arXiv2026

MedRiskEval: Medical Risk Evaluation Benchmark of Language Models, On the Importance of User Perspectives in Healthcare Settings

As the performance of large language models (LLMs) continues to advance, their adoption in the medical domain is increasing. However, most existing risk evaluations largely focused on general safety benchmarks. In the medical applications, LLMs may be used by a wide range of users, ranging from general users and patients to clinicians, with diverse levels of expertise and the model's outputs can have a direct impact on human health which raises serious safety concerns. In this paper, we introduce MedRiskEval, a medical risk evaluation benchmark tailored to the medical domain. To fill the gap in previous benchmarks that only focused on the clinician perspective, we introduce a new patient-oriented dataset called PatientSafetyBench containing 466 samples across 5 critical risk categories. Leveraging our new benchmark alongside existing datasets, we evaluate a variety of open- and closed-source LLMs. To the best of our knowledge, this work establishes an initial foundation for safer deployment of LLMs in healthcare.

cs.CL↗

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

Empowering Healthcare Practitioners with Language Models: Structuring Speech Transcripts in Two Real-World Clinical Applications

Large language models (LLMs) such as GPT-4o and o1 have demonstrated strong performance on clinical natural language processing (NLP) tasks across multiple medical benchmarks. Nonetheless, two high-impact NLP tasks - structured tabular reporting from nurse dictations and medical order extraction from doctor-patient consultations - remain underexplored due to data scarcity and sensitivity, despite active industry efforts. Practical solutions to these real-world clinical tasks can significantly reduce the documentation burden on healthcare providers, allowing greater focus on patient care. In this paper, we investigate these two challenging tasks using private and open-source clinical datasets, evaluating the performance of both open- and closed-weight LLMs, and analyzing their respective strengths and limitations. Furthermore, we propose an agentic pipeline for generating realistic, non-sensitive nurse dictations, enabling structured extraction of clinical observations. To support further research in both areas, we release SYNUR and SIMORD, the first open-source datasets for nurse observation extraction and medical order extraction.

cs.CL↗

arXiv2025

AURAD: Anatomy-Pathology Unified Radiology Synthesis with Progressive Representations

Medical image synthesis has become an essential strategy for augmenting datasets and improving model generalization in data-scarce clinical settings. However, fine-grained and controllable synthesis remains difficult due to limited high-quality annotations and domain shifts across datasets. Existing methods, often designed for natural images or well-defined tumors, struggle to generalize to chest radiographs, where disease patterns are morphologically diverse and tightly intertwined with anatomical structures. To address these challenges, we propose AURAD, a controllable radiology synthesis framework that jointly generates high-fidelity chest X-rays and pseudo semantic masks. Unlike prior approaches that rely on randomly sampled masks-limiting diversity, controllability, and clinical relevance-our method learns to generate masks that capture multi-pathology coexistence and anatomical-pathological consistency. It follows a progressive pipeline: pseudo masks are first generated from clinical prompts conditioned on anatomical structures, and then used to guide image synthesis. We also leverage pretrained expert medical models to filter outputs and ensure clinical plausibility. Beyond visual realism, the synthesized masks also serve as labels for downstream tasks such as detection and segmentation, bridging the gap between generative modeling and real-world clinical applications. Extensive experiments and blinded radiologist evaluations demonstrate the effectiveness and generalizability of our method across tasks and datasets. In particular, 78% of our synthesized images are classified as authentic by board-certified radiologists, and over 40% of predicted segmentation overlays are rated as clinically useful. All code, pre-trained models, and the synthesized dataset will be released upon publication.

eess.IV↗

arXiv2025

A Modular Approach for Clinical SLMs Driven by Synthetic Data with Pre-Instruction Tuning, Model Merging, and Clinical-Tasks Alignment

High computation costs and latency of large language models such as GPT-4 have limited their deployment in clinical settings. Small language models (SLMs) offer a cost-effective alternative, but their limited capacity requires biomedical domain adaptation, which remains challenging. An additional bottleneck is the unavailability and high sensitivity of clinical data. To address these challenges, we propose a novel framework for adapting SLMs into high-performing clinical models. We introduce the MediPhi collection of 3.8B-parameter SLMs developed with our novel framework: pre-instruction tuning of experts on relevant medical and clinical corpora (PMC, Medical Guideline, MedWiki, etc.), model merging, and clinical-tasks alignment. To cover most clinical tasks, we extended the CLUE benchmark to CLUE+, doubling its size. Our expert models deliver relative improvements on this benchmark over the base model without any task-specific fine-tuning: 64.3% on medical entities, 49.5% on radiology reports, and 44% on ICD-10 coding (outperforming GPT-4-0125 by 14%). We unify the expert models into MediPhi via model merging, preserving gains across benchmarks. Furthermore, we built the MediFlow collection, a synthetic dataset of 2.5 million high-quality instructions on 14 medical NLP tasks, 98 fine-grained document types, and JSON format support. Alignment of MediPhi using supervised fine-tuning and direct preference optimization achieves further gains of 18.9% on average.

cs.CL↗

arXiv2025

X-Reasoner: Towards Generalizable Reasoning Across Modalities and Domains

Recent proprietary models (e.g., o3) have begun to demonstrate strong multimodal reasoning capabilities. Yet, most existing open-source research concentrates on training text-only reasoning models, with evaluations limited to mainly mathematical and general-domain tasks. Therefore, it remains unclear how to effectively extend reasoning capabilities beyond text input and general domains. This paper explores a fundamental research question: Is reasoning generalizable across modalities and domains? Our findings support an affirmative answer: General-domain text-based post-training can enable such strong generalizable reasoning. Leveraging this finding, we introduce X-Reasoner, a vision-language model post-trained solely on general-domain text for generalizable reasoning, using a two-stage approach: an initial supervised fine-tuning phase with distilled long chain-of-thoughts, followed by reinforcement learning with verifiable rewards. Experiments show that X-Reasoner successfully transfers reasoning capabilities to both multimodal and out-of-domain settings, outperforming existing state-of-the-art models trained with in-domain and multimodal data across various general and medical benchmarks (Figure 1). Additionally, we find that X-Reasoner's performance in specialized domains can be further enhanced through continued training on domain-specific text-only data. Building upon this, we introduce X-Reasoner-Med, a medical-specialized variant that achieves new state of the art on numerous text-only and multimodal medical benchmarks.

cs.AI↗

arXiv2024

Attribute Structuring Improves LLM-Based Evaluation of Clinical Text Summaries

Summarizing clinical text is crucial in health decision-support and clinical research. Large language models (LLMs) have shown the potential to generate accurate clinical text summaries, but still struggle with issues regarding grounding and evaluation, especially in safety-critical domains such as health. Holistically evaluating text summaries is challenging because they may contain unsubstantiated information. Here, we explore a general mitigation framework using Attribute Structuring (AS), which structures the summary evaluation process. It decomposes the evaluation process into a grounded procedure that uses an LLM for relatively simple structuring and scoring tasks, rather than the full task of holistic summary evaluation. Experiments show that AS consistently improves the correspondence between human annotations and automated metrics in clinical text summarization. Additionally, AS yields interpretations in the form of a short text span corresponding to each output, which enables efficient human auditing, paving the way towards trustworthy evaluation of clinical information in resource-constrained scenarios. We release our code, prompts, and an open-source benchmark at https://github.com/microsoft/attribute-structuring.

cs.CL↗

arXiv2022

Contextual Density Ratio for Language Model Biasing of Sequence to Sequence ASR Systems

End-2-end (E2E) models have become increasingly popular in some ASR tasks because of their performance and advantages. These E2E models directly approximate the posterior distribution of tokens given the acoustic inputs. Consequently, the E2E systems implicitly define a language model (LM) over the output tokens, which makes the exploitation of independently trained language models less straightforward than in conventional ASR systems. This makes it difficult to dynamically adapt E2E ASR system to contextual profiles for better recognizing special words such as named entities. In this work, we propose a contextual density ratio approach for both training a contextual aware E2E model and adapting the language model to named entities. We apply the aforementioned technique to an E2E ASR system, which transcribes doctor and patient conversations, for better adapting the E2E system to the names in the conversations. Our proposed technique achieves a relative improvement of up to 46.5% on the names over an E2E baseline without degrading the overall recognition accuracy of the whole test set. Moreover, it also surpasses a contextual shallow fusion baseline by 22.1 % relative.

eess.AS↗

arXiv2021

Retrieval-Augmented Transformer-XL for Close-Domain Dialog Generation

Transformer-based models have demonstrated excellent capabilities of capturing patterns and structures in natural language generation and achieved state-of-the-art results in many tasks. In this paper we present a transformer-based model for multi-turn dialog response generation. Our solution is based on a hybrid approach which augments a transformer-based generative model with a novel retrieval mechanism, which leverages the memorized information in the training data via k-Nearest Neighbor search. Our system is evaluated on two datasets made by customer/assistant dialogs: the Taskmaster-1, released by Google and holding high quality, goal-oriented conversational data and a proprietary dataset collected from a real customer service call center. Both achieve better BLEU scores over strong baselines.

cs.CL↗

arXiv2019

DeepAAA: clinically applicable and generalizable detection of abdominal aortic aneurysm using deep learning

We propose a deep learning-based technique for detection and quantification of abdominal aortic aneurysms (AAAs). The condition, which leads to more than 10,000 deaths per year in the United States, is asymptomatic, often detected incidentally, and often missed by radiologists. Our model architecture is a modified 3D U-Net combined with ellipse fitting that performs aorta segmentation and AAA detection. The study uses 321 abdominal-pelvic CT examinations performed by Massachusetts General Hospital Department of Radiology for training and validation. The model is then further tested for generalizability on a separate set of 57 examinations with differing patient demographics and acquisition characteristics than the original dataset. DeepAAA achieves high performance on both sets of data (sensitivity/specificity 0.91/0.95 and 0.85 / 1.0 respectively), on contrast and non-contrast CT scans and works with image volumes with varying numbers of images. We find that DeepAAA exceeds literature-reported performance of radiologists on incidental AAA detection. It is expected that the model can serve as an effective background detector in routine CT examinations to prevent incidental AAAs from being missed.

eess.IV↗