Daily Papers

Although Large Reasoning Models (LRMs) have progressed in solving complex problems, their chain-of-thought (CoT) reasoning often contains harmful content that can persist even when the final responses appear safe. We show that this issue still remains in existing methods which overlook the unique significance of safe reasoning, undermining their trustworthiness and posing potential risks in applications if unsafe reasoning is accessible for and exploited by malicious users. We therefore shift our focus to aligning the safety of reasoning itself in this paper and explore process supervision as the solution. However, simply rewarding safe reasoning proves inadequate due to low rollout diversity and limited training signals. To tackle this challenge, we first delve into the characteristics of safe reasoning and uncover several critical insights that 1) safe reasoning is often consolidated by a few critical steps of safety triggers; 2) compliance cues strongly correlate with unsafe continuations; and 3) corrective interventions reliably steer unsafe trajectories towards safer traces. Motivated by these, we propose Intervened Preference Optimization (IPO), an alignment method that enforces safe reasoning by substituting compliance steps with safety triggers and constructing pairs for preference learning with strong signals. Experiments on jailbreak and adversarial safety benchmarks demonstrate that IPO remarkably improves overall safety regarding both reasoning and responses, outperforming SFT-based and RL-based baselines with a relative reduction of over 30% in harmfulness, while preserving excellent performance across diverse reasoning tasks. The results highlight the importance of explicit alignment for reasoning and provide a practical path to safer LRMs.

Failure attribution in multi-agent systems -- pinpointing the exact step where a decisive error occurs -- is a critical yet unsolved challenge. Current methods treat this as a pattern recognition task over long conversation logs, leading to critically low step-level accuracy (below 17\%), which renders them impractical for debugging complex systems. Their core weakness is a fundamental inability to perform robust counterfactual reasoning: to determine if correcting a single action would have actually averted the task failure. To bridge this counterfactual inference gap, we introduce Abduct-Act-Predict (A2P) Scaffolding, a novel agent framework that transforms failure attribution from pattern recognition into a structured causal inference task. A2P explicitly guides a large language model through a formal three-step reasoning process within a single inference pass: (1) Abduction, to infer the hidden root causes behind an agent's actions; (2) Action, to define a minimal corrective intervention; and (3) Prediction, to simulate the subsequent trajectory and verify if the intervention resolves the failure. This structured approach leverages the holistic context of the entire conversation while imposing a rigorous causal logic on the model's analysis. Our extensive experiments on the Who\&When benchmark demonstrate its efficacy. On the Algorithm-Generated dataset, A2P achieves 47.46\% step-level accuracy, a 2.85times improvement over the 16.67\% of the baseline. On the more complex Hand-Crafted dataset, it achieves 29.31\% step accuracy, a 2.43times improvement over the baseline's 12.07\%. By reframing the problem through a causal lens, A2P Scaffolding provides a robust, verifiable, and significantly more accurate solution for automated failure attribution. Ours code are released at https://github.com/ResearAI/A2P.

Text data can pose a risk of harm. However, the risks are not fully understood, and how to handle, present, and discuss harmful text in a safe way remains an unresolved issue in the NLP community. We provide an analytical framework categorising harms on three axes: (1) the harm type (e.g., misinformation, hate speech or racial stereotypes); (2) whether a harm is sought as a feature of the research design if explicitly studying harmful content (e.g., training a hate speech classifier), versus unsought if harmful content is encountered when working on unrelated problems (e.g., language generation or part-of-speech tagging); and (3) who it affects, from people (mis)represented in the data to those handling the data and those publishing on the data. We provide advice for practitioners, with concrete steps for mitigating harm in research and in publication. To assist implementation we introduce HarmCheck -- a documentation standard for handling and presenting harmful text in research.

Test-time interventions for language models can enhance factual accuracy, mitigate harmful outputs, and improve model efficiency without costly retraining. But despite a flood of new methods, different types of interventions are largely developing independently. In practice, multiple interventions must be applied sequentially to the same model, yet we lack standardized ways to study how interventions interact. We fill this gap by introducing composable interventions, a framework to study the effects of using multiple interventions on the same language models, featuring new metrics and a unified codebase. Using our framework, we conduct extensive experiments and compose popular methods from three emerging intervention categories -- Knowledge Editing, Model Compression, and Machine Unlearning. Our results from 310 different compositions uncover meaningful interactions: compression hinders editing and unlearning, composing interventions hinges on their order of application, and popular general-purpose metrics are inadequate for assessing composability. Taken together, our findings showcase clear gaps in composability, suggesting a need for new multi-objective interventions. All of our code is public: https://github.com/hartvigsen-group/composable-interventions.

In-context learning (ICL) has transformed the use of large language models (LLMs) for NLP tasks, enabling few-shot learning by conditioning on labeled examples without finetuning. Despite its effectiveness, ICL is prone to errors, especially for challenging examples. With the goal of improving the performance of ICL, we propose corrective in-context learning (CICL), an approach that incorporates a model's incorrect predictions alongside ground truth corrections into the prompt, aiming to enhance classification accuracy through self-correction. However, contrary to our hypothesis, extensive experiments on text classification tasks demonstrate that CICL consistently underperforms standard ICL, with performance degrading as the proportion of corrections in the prompt increases. Our findings indicate that CICL introduces confusion by disrupting the model's task understanding, rather than refining its predictions. Additionally, we observe that presenting harder examples in standard ICL does not improve performance, suggesting that example difficulty alone may not be a reliable criterion for effective selection. By presenting these negative results, we provide important insights into the limitations of self-corrective mechanisms in LLMs and offer directions for future research.

We introduce Inference-Time Intervention (ITI), a technique designed to enhance the truthfulness of large language models (LLMs). ITI operates by shifting model activations during inference, following a set of directions across a limited number of attention heads. This intervention significantly improves the performance of LLaMA models on the TruthfulQA benchmark. On an instruction-finetuned LLaMA called Alpaca, ITI improves its truthfulness from 32.5% to 65.1%. We identify a tradeoff between truthfulness and helpfulness and demonstrate how to balance it by tuning the intervention strength. ITI is minimally invasive and computationally inexpensive. Moreover, the technique is data efficient: while approaches like RLHF require extensive annotations, ITI locates truthful directions using only few hundred examples. Our findings suggest that LLMs may have an internal representation of the likelihood of something being true, even as they produce falsehoods on the surface.

In this work we propose a blackbox intervention method for visual dialog models, with the aim of assessing the contribution of individual linguistic or visual components. Concretely, we conduct structured or randomized interventions that aim to impair an individual component of the model, and observe changes in task performance. We reproduce a state-of-the-art visual dialog model and demonstrate that our methodology yields surprising insights, namely that both dialog and image information have minimal contributions to task performance. The intervention method presented here can be applied as a sanity check for the strength and robustness of each component in visual dialog systems.

The acceleration in the adoption of AI-based automated decision-making systems poses a challenge for evaluating the fairness of algorithmic decisions, especially in the absence of ground truth. When designing interventions, uplift modeling is used extensively to identify candidates that are likely to benefit from treatment. However, these models remain particularly susceptible to fairness evaluation due to the lack of ground truth on the outcome measure since a candidate cannot be in both treatment and control simultaneously. In this article, we propose a framework that overcomes the missing ground truth problem by generating surrogates to serve as a proxy for counterfactual labels of uplift modeling campaigns. We then leverage the surrogate ground truth to conduct a more comprehensive binary fairness evaluation. We show how to apply the approach in a comprehensive study from a real-world marketing campaign for promotional offers and demonstrate its enhancement for fairness evaluation.

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

The recent phenomenal success of language models has reinvigorated machine learning research, and large sequence models such as transformers are being applied to a variety of domains. One important problem class that has remained relatively elusive however is purposeful adaptive behavior. Currently there is a common perception that sequence models "lack the understanding of the cause and effect of their actions" leading them to draw incorrect inferences due to auto-suggestive delusions. In this report we explain where this mismatch originates, and show that it can be resolved by treating actions as causal interventions. Finally, we show that in supervised learning, one can teach a system to condition or intervene on data by training with factual and counterfactual error signals respectively.

We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.

Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.

Artificial intelligence (AI) systems will increasingly be used to cause harm as they grow more capable. In fact, AI systems are already starting to be used to automate fraudulent activities, violate human rights, create harmful fake images, and identify dangerous toxins. To prevent some misuses of AI, we argue that targeted interventions on certain capabilities will be warranted. These restrictions may include controlling who can access certain types of AI models, what they can be used for, whether outputs are filtered or can be traced back to their user, and the resources needed to develop them. We also contend that some restrictions on non-AI capabilities needed to cause harm will be required. Though capability restrictions risk reducing use more than misuse (facing an unfavorable Misuse-Use Tradeoff), we argue that interventions on capabilities are warranted when other interventions are insufficient, the potential harm from misuse is high, and there are targeted ways to intervene on capabilities. We provide a taxonomy of interventions that can reduce AI misuse, focusing on the specific steps required for a misuse to cause harm (the Misuse Chain), and a framework to determine if an intervention is warranted. We apply this reasoning to three examples: predicting novel toxins, creating harmful images, and automating spear phishing campaigns.

Transformer-based language models have been shown to be highly effective for several NLP tasks. In this paper, we consider three transformer models, BERT, RoBERTa, and XLNet, in both small and large version, and investigate how faithful their representations are with respect to the semantic content of texts. We formalize a notion of semantic faithfulness, in which the semantic content of a text should causally figure in a model's inferences in question answering. We then test this notion by observing a model's behavior on answering questions about a story after performing two novel semantic interventions -- deletion intervention and negation intervention. While transformer models achieve high performance on standard question answering tasks, we show that they fail to be semantically faithful once we perform these interventions for a significant number of cases (~50% for deletion intervention, and ~20% drop in accuracy for negation intervention). We then propose an intervention-based training regime that can mitigate the undesirable effects for deletion intervention by a significant margin (from ~50% to ~6%). We analyze the inner-workings of the models to better understand the effectiveness of intervention-based training for deletion intervention. But we show that this training does not attenuate other aspects of semantic unfaithfulness such as the models' inability to deal with negation intervention or to capture the predicate-argument structure of texts. We also test InstructGPT, via prompting, for its ability to handle the two interventions and to capture predicate-argument structure. While InstructGPT models do achieve very high performance on predicate-argument structure task, they fail to respond adequately to our deletion and negation interventions.

Effective mental health support is crucial for alleviating psychological distress. While large language model (LLM)-based assistants have shown promise in mental health interventions, existing research often defines "effective" support primarily in terms of empathetic acknowledgments, overlooking other essential dimensions such as informational guidance, community validation, and tangible coping strategies. To address this limitation and better understand what constitutes effective support, we introduce RedditESS, a novel real-world dataset derived from Reddit posts, including supportive comments and original posters' follow-up responses. Grounded in established social science theories, we develop an ensemble labeling mechanism to annotate supportive comments as effective or not and perform qualitative assessments to ensure the reliability of the annotations. Additionally, we demonstrate the practical utility of RedditESS by using it to guide LLM alignment toward generating more context-sensitive and genuinely helpful supportive responses. By broadening the understanding of effective support, our study paves the way for advanced AI-driven mental health interventions.

Despite advances in large language models (LLMs) on reasoning and instruction-following benchmarks, it remains unclear whether they can reliably produce outputs aligned with a broad variety of user goals, a concept we refer to as steerability. The abundance of methods proposed to modify LLM behavior makes it unclear whether current LLMs are already steerable, or require further intervention. In particular, LLMs may exhibit (i) poor coverage, where rare user goals are underrepresented; (ii) miscalibration, where models overshoot requests; and (iii) side effects, where changes to one dimension of text inadvertently affect others. To systematically evaluate these failures, we introduce a framework based on a multi-dimensional goal space that models user goals and LLM outputs as vectors with dimensions corresponding to text attributes (e.g., reading difficulty). Applied to a text-rewriting task, we find that current LLMs struggle with steerability, as side effects are persistent. Interventions to improve steerability, such as prompt engineering, best-of-N sampling, and reinforcement learning fine-tuning, have varying effectiveness, yet side effects remain problematic. Our findings suggest that even strong LLMs struggle with steerability, and existing alignment strategies may be insufficient. We open-source our steerability evaluation framework at https://github.com/MLD3/steerability.

Interventions targeting the representation space of language models (LMs) have emerged as an effective means to influence model behavior. Such methods are employed, for example, to eliminate or alter the encoding of demographic information such as gender within the model's representations and, in so doing, create a counterfactual representation. However, because the intervention operates within the representation space, understanding precisely what aspects of the text it modifies poses a challenge. In this paper, we give a method to convert representation counterfactuals into string counterfactuals. We demonstrate that this approach enables us to analyze the linguistic alterations corresponding to a given representation space intervention and to interpret the features utilized to encode a specific concept. Moreover, the resulting counterfactuals can be used to mitigate bias in classification through data augmentation.

Interventions on model-internal states are fundamental operations in many areas of AI, including model editing, steering, robustness, and interpretability. To facilitate such research, we introduce pyvene, an open-source Python library that supports customizable interventions on a range of different PyTorch modules. pyvene supports complex intervention schemes with an intuitive configuration format, and its interventions can be static or include trainable parameters. We show how pyvene provides a unified and extensible framework for performing interventions on neural models and sharing the intervened upon models with others. We illustrate the power of the library via interpretability analyses using causal abstraction and knowledge localization. We publish our library through Python Package Index (PyPI) and provide code, documentation, and tutorials at https://github.com/stanfordnlp/pyvene.

Large language models (LLMs) are rapidly transitioning into medical clinical use, yet their reliability under realistic, multi-turn interactions remains poorly understood. Existing evaluation frameworks typically assess single-turn question answering under idealized conditions, overlooking the complexities of medical consultations where conflicting input, misleading context, and authority influence are common. We introduce MedQA-Followup, a framework for systematically evaluating multi-turn robustness in medical question answering. Our approach distinguishes between shallow robustness (resisting misleading initial context) and deep robustness (maintaining accuracy when answers are challenged across turns), while also introducing an indirect-direct axis that separates contextual framing (indirect) from explicit suggestion (direct). Using controlled interventions on the MedQA dataset, we evaluate five state-of-the-art LLMs and find that while models perform reasonably well under shallow perturbations, they exhibit severe vulnerabilities in multi-turn settings, with accuracy dropping from 91.2% to as low as 13.5% for Claude Sonnet 4. Counterintuitively, indirect, context-based interventions are often more harmful than direct suggestions, yielding larger accuracy drops across models and exposing a significant vulnerability for clinical deployment. Further compounding analyses reveal model differences, with some showing additional performance drops under repeated interventions while others partially recovering or even improving. These findings highlight multi-turn robustness as a critical but underexplored dimension for safe and reliable deployment of medical LLMs.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.

In natural language processing applied to the clinical domain, utilizing large language models has emerged as a promising avenue for error detection and correction on clinical notes, a knowledge-intensive task for which annotated data is scarce. This paper presents MedReAct'N'MedReFlex, which leverages a suite of four LLM-based medical agents. The MedReAct agent initiates the process by observing, analyzing, and taking action, generating trajectories to guide the search to target a potential error in the clinical notes. Subsequently, the MedEval agent employs five evaluators to assess the targeted error and the proposed correction. In cases where MedReAct's actions prove insufficient, the MedReFlex agent intervenes, engaging in reflective analysis and proposing alternative strategies. Finally, the MedFinalParser agent formats the final output, preserving the original style while ensuring the integrity of the error correction process. One core component of our method is our RAG pipeline based on our ClinicalCorp corpora. Among other well-known sources containing clinical guidelines and information, we preprocess and release the open-source MedWiki dataset for clinical RAG application. Our results demonstrate the central role of our RAG approach with ClinicalCorp leveraged through the MedReAct'N'MedReFlex framework. It achieved the ninth rank on the MEDIQA-CORR 2024 final leaderboard.

Today's robot policies exhibit subpar performance when faced with the challenge of generalizing to novel environments. Human corrective feedback is a crucial form of guidance to enable such generalization. However, adapting to and learning from online human corrections is a non-trivial endeavor: not only do robots need to remember human feedback over time to retrieve the right information in new settings and reduce the intervention rate, but also they would need to be able to respond to feedback that can be arbitrary corrections about high-level human preferences to low-level adjustments to skill parameters. In this work, we present Distillation and Retrieval of Online Corrections (DROC), a large language model (LLM)-based system that can respond to arbitrary forms of language feedback, distill generalizable knowledge from corrections, and retrieve relevant past experiences based on textual and visual similarity for improving performance in novel settings. DROC is able to respond to a sequence of online language corrections that address failures in both high-level task plans and low-level skill primitives. We demonstrate that DROC effectively distills the relevant information from the sequence of online corrections in a knowledge base and retrieves that knowledge in settings with new task or object instances. DROC outperforms other techniques that directly generate robot code via LLMs by using only half of the total number of corrections needed in the first round and requires little to no corrections after two iterations. We show further results, videos, prompts and code on https://sites.google.com/stanford.edu/droc .

We test the hypothesis that language models trained with reinforcement learning from human feedback (RLHF) have the capability to "morally self-correct" -- to avoid producing harmful outputs -- if instructed to do so. We find strong evidence in support of this hypothesis across three different experiments, each of which reveal different facets of moral self-correction. We find that the capability for moral self-correction emerges at 22B model parameters, and typically improves with increasing model size and RLHF training. We believe that at this level of scale, language models obtain two capabilities that they can use for moral self-correction: (1) they can follow instructions and (2) they can learn complex normative concepts of harm like stereotyping, bias, and discrimination. As such, they can follow instructions to avoid certain kinds of morally harmful outputs. We believe our results are cause for cautious optimism regarding the ability to train language models to abide by ethical principles.

Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.

Large language models (LLMs) have demonstrated remarkable performance across a wide array of NLP tasks. However, their efficacy is undermined by undesired and inconsistent behaviors, including hallucination, unfaithful reasoning, and toxic content. A promising approach to rectify these flaws is self-correction, where the LLM itself is prompted or guided to fix problems in its own output. Techniques leveraging automated feedback -- either produced by the LLM itself or some external system -- are of particular interest as they are a promising way to make LLM-based solutions more practical and deployable with minimal human feedback. This paper presents a comprehensive review of this emerging class of techniques. We analyze and taxonomize a wide array of recent work utilizing these strategies, including training-time, generation-time, and post-hoc correction. We also summarize the major applications of this strategy and conclude by discussing future directions and challenges.

Steering the behavior of Large Language Models (LLMs) remains a challenge, particularly in engineering applications where precision and reliability are critical. While fine-tuning and prompting methods can modify model behavior, they lack the dynamic and exact control necessary for engineering applications. Inference-time intervention techniques provide a promising alternative, allowing targeted adjustments to LLM outputs. In this work, we demonstrate how interventions enable fine-grained control for automating the usually time-intensive requirement verification process in Model-Based Systems Engineering (MBSE). Using two early-stage Capella SysML models of space missions with associated requirements, we apply the intervened LLMs to reason over a graph representation of the model to determine whether a requirement is fulfilled. Our method achieves robust and reliable outputs, significantly improving over both a baseline model and a fine-tuning approach. By identifying and modifying as few as one to three specialised attention heads, we can significantly change the model's behavior. When combined with self-consistency, this allows us to achieve perfect precision on our holdout test set.

Large LMs such as GPT-3 are powerful, but can commit mistakes that are obvious to humans. For example, GPT-3 would mistakenly interpret "What word is similar to good?" to mean a homophone, while the user intended a synonym. Our goal is to effectively correct such errors via user interactions with the system but without retraining, which will be prohibitively costly. We pair GPT-3 with a growing memory of recorded cases where the model misunderstood the user's intents, along with user feedback for clarification. Such a memory allows our system to produce enhanced prompts for any new query based on the user feedback for error correction on similar cases in the past. On four tasks (two lexical tasks, two advanced ethical reasoning tasks), we show how a (simulated) user can interactively teach a deployed GPT-3, substantially increasing its accuracy over the queries with different kinds of misunderstandings by the GPT-3. Our approach is a step towards the low-cost utility enhancement for very large pre-trained LMs. Code, data, and instructions to implement MEMPROMPT for a new task at https://www.memprompt.com/.

Machine Learning models increasingly face data integrity challenges due to the use of large-scale training datasets drawn from the Internet. We study what model developers can do if they detect that some data was manipulated or incorrect. Such manipulated data can cause adverse effects including vulnerability to backdoored samples, systemic biases, and reduced accuracy on certain input domains. Realistically, all manipulated training samples cannot be identified, and only a small, representative subset of the affected data can be flagged. We formalize Corrective Machine Unlearning as the problem of mitigating the impact of data affected by unknown manipulations on a trained model, only having identified a subset of the corrupted data. We demonstrate that the problem of corrective unlearning has significantly different requirements from traditional privacy-oriented unlearning. We find most existing unlearning methods, including retraining-from-scratch without the deletion set, require most of the manipulated data to be identified for effective corrective unlearning. However, one approach, Selective Synaptic Dampening, achieves limited success, unlearning adverse effects with just a small portion of the manipulated samples in our setting, which shows encouraging signs for future progress. We hope our work spurs research towards developing better methods for corrective unlearning and offers practitioners a new strategy to handle data integrity challenges arising from web-scale training. Code is available at https://github.com/drimpossible/corrective-unlearning-bench.

Millions of users come to online peer counseling platforms to seek support on diverse topics ranging from relationship stress to anxiety. However, studies show that online peer support groups are not always as effective as expected largely due to users' negative experiences with unhelpful counselors. Peer counselors are key to the success of online peer counseling platforms, but most of them often do not have systematic ways to receive guidelines or supervision. In this work, we introduce CARE: an interactive AI-based tool to empower peer counselors through automatic suggestion generation. During the practical training stage, CARE helps diagnose which specific counseling strategies are most suitable in the given context and provides tailored example responses as suggestions. Counselors can choose to select, modify, or ignore any suggestion before replying to the support seeker. Building upon the Motivational Interviewing framework, CARE utilizes large-scale counseling conversation data together with advanced natural language generation techniques to achieve these functionalities. We demonstrate the efficacy of CARE by performing both quantitative evaluations and qualitative user studies through simulated chats and semi-structured interviews. We also find that CARE especially helps novice counselors respond better in challenging situations.

Online misinformation poses a global risk with harmful implications for society. Ordinary social media users are known to actively reply to misinformation posts with counter-misinformation messages, which is shown to be effective in containing the spread of misinformation. Such a practice is defined as "social correction". Nevertheless, it remains unknown how users respond to social correction in real-world scenarios, especially, will it have a corrective or backfire effect on users. Investigating this research question is pivotal for developing and refining strategies that maximize the efficacy of social correction initiatives. To fill this gap, we conduct an in-depth study to characterize and predict the user response to social correction in a data-driven manner through the lens of X (Formerly Twitter), where the user response is instantiated as the reply that is written toward a counter-misinformation message. Particularly, we first create a novel dataset with 55, 549 triples of misinformation tweets, counter-misinformation replies, and responses to counter-misinformation replies, and then curate a taxonomy to illustrate different kinds of user responses. Next, fine-grained statistical analysis of reply linguistic and engagement features as well as repliers' user attributes is conducted to illustrate the characteristics that are significant in determining whether a reply will have a corrective or backfire effect. Finally, we build a user response prediction model to identify whether a social correction will be corrective, neutral, or have a backfire effect, which achieves a promising F1 score of 0.816. Our work enables stakeholders to monitor and predict user responses effectively, thus guiding the use of social correction to maximize their corrective impact and minimize backfire effects. The code and data is accessible on https://github.com/claws-lab/response-to-social-correction.

Large language models (LLMs) have achieved remarkable performance across many generation tasks. Nevertheless, effectively aligning them with desired behaviors remains a significant challenge. Activation steering is an effective and cost-efficient approach that directly modifies the activations of LLMs during the inference stage, aligning their responses with the desired behaviors and avoiding the high cost of fine-tuning. Existing methods typically indiscriminately intervene to all generations or rely solely on the question to determine intervention, which limits the accurate assessment of the intervention strength. To this end, we propose the Flexible Activation Steering with Backtracking (FASB) framework, which dynamically determines both the necessity and strength of intervention by tracking the internal states of the LLMs during generation, considering both the question and the generated content. Since intervening after detecting a deviation from the desired behavior is often too late, we further propose the backtracking mechanism to correct the deviated tokens and steer the LLMs toward the desired behavior. Extensive experiments on the TruthfulQA dataset and six multiple-choice datasets demonstrate that our method outperforms baselines. Our code will be released at https://github.com/gjw185/FASB.

Prompt-based "diversity interventions" are commonly adopted to improve the diversity of Text-to-Image (T2I) models depicting individuals with various racial or gender traits. However, will this strategy result in nonfactual demographic distribution, especially when generating real historical figures? In this work, we propose DemOgraphic FActualIty Representation (DoFaiR), a benchmark to systematically quantify the trade-off between using diversity interventions and preserving demographic factuality in T2I models. DoFaiR consists of 756 meticulously fact-checked test instances to reveal the factuality tax of various diversity prompts through an automated evidence-supported evaluation pipeline. Experiments on DoFaiR unveil that diversity-oriented instructions increase the number of different gender and racial groups in DALLE-3's generations at the cost of historically inaccurate demographic distributions. To resolve this issue, we propose Fact-Augmented Intervention (FAI), which instructs a Large Language Model (LLM) to reflect on verbalized or retrieved factual information about gender and racial compositions of generation subjects in history, and incorporate it into the generation context of T2I models. By orienting model generations using the reflected historical truths, FAI significantly improves the demographic factuality under diversity interventions while preserving diversity.

The recent success of Large Language Models (LLMs) has catalyzed an increasing interest in their self-correction capabilities. This paper presents a comprehensive investigation into the intrinsic self-correction of LLMs, attempting to address the ongoing debate about its feasibility. Our research has identified an important latent factor - the "confidence" of LLMs - during the self-correction process. Overlooking this factor may cause the models to over-criticize themselves, resulting in unreliable conclusions regarding the efficacy of self-correction. We have experimentally observed that LLMs possess the capability to understand the "confidence" in their own responses. It motivates us to develop an "If-or-Else" (IoE) prompting framework, designed to guide LLMs in assessing their own "confidence", facilitating intrinsic self-corrections. We conduct extensive experiments and demonstrate that our IoE-based Prompt can achieve a consistent improvement regarding the accuracy of self-corrected responses over the initial answers. Our study not only sheds light on the underlying factors affecting self-correction in LLMs, but also introduces a practical framework that utilizes the IoE prompting principle to efficiently improve self-correction capabilities with "confidence". The code is available at https://github.com/MBZUAI-CLeaR/IoE-Prompting.git.

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

Large Language Models (LLMs) present an intriguing avenue for exploration in the field of formal theorem proving. Nevertheless, their full potential, particularly concerning the mitigation of hallucinations and refinement through prover error messages, remains an area that has yet to be thoroughly investigated. To enhance the effectiveness of LLMs in the field, we introduce the Lyra, a new framework that employs two distinct correction mechanisms: Tool Correction (TC) and Conjecture Correction (CC). To implement Tool Correction in the post-processing of formal proofs, we leverage prior knowledge to utilize predefined prover tools (e.g., Sledgehammer) for guiding the replacement of incorrect tools. Tool Correction significantly contributes to mitigating hallucinations, thereby improving the overall accuracy of the proof. In addition, we introduce Conjecture Correction, an error feedback mechanism designed to interact with prover to refine formal proof conjectures with prover error messages. Compared to the previous refinement framework, the proposed Conjecture Correction refines generation with instruction but does not collect paired (generation, error & refinement) prompts. Our method has achieved state-of-the-art (SOTA) performance on both miniF2F validation (48.0% -> 55.3%) and test (45.5% -> 51.2%). We also present 3 IMO problems solved by Lyra. We believe Tool Correction (post-process for hallucination mitigation) and Conjecture Correction (subgoal adjustment from interaction with environment) could provide a promising avenue for future research in this field.

Aligned representations across languages is a desired property in multilingual large language models (mLLMs), as alignment can improve performance in cross-lingual tasks. Typically alignment requires fine-tuning a model, which is computationally expensive, and sizable language data, which often may not be available. A data-efficient alternative to fine-tuning is model interventions -- a method for manipulating model activations to steer generation into the desired direction. We analyze the effect of a popular intervention (finding experts) on the alignment of cross-lingual representations in mLLMs. We identify the neurons to manipulate for a given language and introspect the embedding space of mLLMs pre- and post-manipulation. We show that modifying the mLLM's activations changes its embedding space such that cross-lingual alignment is enhanced. Further, we show that the changes to the embedding space translate into improved downstream performance on retrieval tasks, with up to 2x improvements in top-1 accuracy on cross-lingual retrieval.

Health misinformation spreading online poses a significant threat to public health. Researchers have explored methods for automatically generating counterspeech to health misinformation as a mitigation strategy. Existing approaches often produce uniform responses, ignoring that the health literacy level of the audience could affect the accessibility and effectiveness of counterspeech. We propose a Controlled-Literacy framework using retrieval-augmented generation (RAG) with reinforcement learning (RL) to generate tailored counterspeech adapted to different health literacy levels. In particular, we retrieve knowledge aligned with specific health literacy levels, enabling accessible and factual information to support generation. We design a reward function incorporating subjective user preferences and objective readability-based rewards to optimize counterspeech to the target health literacy level. Experiment results show that Controlled-Literacy outperforms baselines by generating more accessible and user-preferred counterspeech. This research contributes to more equitable and impactful public health communication by improving the accessibility and comprehension of counterspeech to health misinformation

Ensuring equitable Artificial Intelligence (AI) in healthcare demands systems that make unbiased decisions across all demographic groups, bridging technical innovation with ethical principles. Foundation Models (FMs), trained on vast datasets through self-supervised learning, enable efficient adaptation across medical imaging tasks while reducing dependency on labeled data. These models demonstrate potential for enhancing fairness, though significant challenges remain in achieving consistent performance across demographic groups. Our review indicates that effective bias mitigation in FMs requires systematic interventions throughout all stages of development. While previous approaches focused primarily on model-level bias mitigation, our analysis reveals that fairness in FMs requires integrated interventions throughout the development pipeline, from data documentation to deployment protocols. This comprehensive framework advances current knowledge by demonstrating how systematic bias mitigation, combined with policy engagement, can effectively address both technical and institutional barriers to equitable AI in healthcare. The development of equitable FMs represents a critical step toward democratizing advanced healthcare technologies, particularly for underserved populations and regions with limited medical infrastructure and computational resources.

Researchers and developers increasingly rely on toxicity scoring to moderate generative language model outputs, in settings such as customer service, information retrieval, and content generation. However, toxicity scoring may render pertinent information inaccessible, rigidify or "value-lock" cultural norms, and prevent language reclamation processes, particularly for marginalized people. In this work, we extend the concept of algorithmic recourse to generative language models: we provide users a novel mechanism to achieve their desired prediction by dynamically setting thresholds for toxicity filtering. Users thereby exercise increased agency relative to interactions with the baseline system. A pilot study (n = 30) supports the potential of our proposed recourse mechanism, indicating improvements in usability compared to fixed-threshold toxicity-filtering of model outputs. Future work should explore the intersection of toxicity scoring, model controllability, user agency, and language reclamation processes -- particularly with regard to the bias that many communities encounter when interacting with generative language models.

Large Language Models (LLMs) are often described as being instances of foundation models - that is, models that transfer strongly across various tasks and conditions in few-show or zero-shot manner, while exhibiting scaling laws that predict function improvement when increasing the pre-training scale. These claims of excelling in different functions and tasks rely on measurements taken across various sets of standardized benchmarks showing high scores for such models. We demonstrate here a dramatic breakdown of function and reasoning capabilities of state-of-the-art models trained at the largest available scales which claim strong function, using a simple, short, conventional common sense problem formulated in concise natural language, easily solvable by humans. The breakdown is dramatic, as models also express strong overconfidence in their wrong solutions, while providing often non-sensical "reasoning"-like explanations akin to confabulations to justify and backup the validity of their clearly failed responses, making them sound plausible. Various standard interventions in an attempt to get the right solution, like various type of enhanced prompting, or urging the models to reconsider the wrong solutions again by multi step re-evaluation, fail. We take these initial observations to the scientific and technological community to stimulate urgent re-assessment of the claimed capabilities of current generation of LLMs, Such re-assessment also requires common action to create standardized benchmarks that would allow proper detection of such basic reasoning deficits that obviously manage to remain undiscovered by current state-of-the-art evaluation procedures and benchmarks. Code for reproducing experiments in the paper and raw experiments data can be found at https://github.com/LAION-AI/AIW

The integration of Monte Carlo Tree Search (MCTS) with Large Language Models (LLMs) has demonstrated significant success in structured, problem-oriented tasks. However, applying these methods to open-ended dialogues, such as those in psychological counseling, presents unique challenges. Unlike tasks with objective correctness, success in therapeutic conversations depends on subjective factors like empathetic engagement, ethical adherence, and alignment with human preferences, for which strict "correctness" criteria are ill-defined. Existing result-oriented MCTS approaches can therefore produce misaligned responses. To address this, we introduce MCTSr-Zero, an MCTS framework designed for open-ended, human-centric dialogues. Its core innovation is "domain alignment", which shifts the MCTS search objective from predefined end-states towards conversational trajectories that conform to target domain principles (e.g., empathy in counseling). Furthermore, MCTSr-Zero incorporates "Regeneration" and "Meta-Prompt Adaptation" mechanisms to substantially broaden exploration by allowing the MCTS to consider fundamentally different initial dialogue strategies. We evaluate MCTSr-Zero in psychological counseling by generating multi-turn dialogue data, which is used to fine-tune an LLM, PsyLLM. We also introduce PsyEval, a benchmark for assessing multi-turn psychological counseling dialogues. Experiments demonstrate that PsyLLM achieves state-of-the-art performance on PsyEval and other relevant metrics, validating MCTSr-Zero's effectiveness in generating high-quality, principle-aligned conversational data for human-centric domains and addressing the LLM challenge of consistently adhering to complex psychological standards.

Large Language Models (LLMs) can correct their self-generated responses, but a decline in accuracy after self-correction is also witnessed. To have a deeper understanding of self-correction, we endeavor to decompose, evaluate, and analyze the self-correction behaviors of LLMs. By enumerating and analyzing answer correctness before and after self-correction, we decompose the self-correction capability into confidence (being confident to correct answers) and critique (turning wrong answers to correct) capabilities, and propose two metrics from a probabilistic perspective to measure these 2 capabilities, along with another metric for overall self-correction capability evaluation. Based on our decomposition and evaluation metrics, we conduct extensive experiments and draw some empirical conclusions. For example, we find different models can exhibit distinct behaviors: some models are confident while others are more critical. We also find the trade-off between the two capabilities (i.e. improving one can lead to a decline in the other) when manipulating model self-correction behavior by prompts or in-context learning. Further, we find a simple yet efficient strategy to improve self-correction capability by transforming Supervision Fine-Tuning (SFT) data format, and our strategy outperforms vanilla SFT in both capabilities and achieves much higher accuracy after self-correction. Our code will be publicly available on GitHub.

In the digital world, memes present a unique challenge for content moderation due to their potential to spread harmful content. Although detection methods have improved, proactive solutions such as intervention are still limited, with current research focusing mostly on text-based content, neglecting the widespread influence of multimodal content like memes. Addressing this gap, we present MemeGuard, a comprehensive framework leveraging Large Language Models (LLMs) and Visual Language Models (VLMs) for meme intervention. MemeGuard harnesses a specially fine-tuned VLM, VLMeme, for meme interpretation, and a multimodal knowledge selection and ranking mechanism (MKS) for distilling relevant knowledge. This knowledge is then employed by a general-purpose LLM to generate contextually appropriate interventions. Another key contribution of this work is the \textbf{Intervening} \textbf{Cyberbullying in Multimodal Memes (ICMM)} dataset, a high-quality, labeled dataset featuring toxic memes and their corresponding human-annotated interventions. We leverage ICMM to test MemeGuard, demonstrating its proficiency in generating relevant and effective responses to toxic memes.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

Mental manipulation severely undermines mental wellness by covertly and negatively distorting decision-making. While there is an increasing interest in mental health care within the natural language processing community, progress in tackling manipulation remains limited due to the complexity of detecting subtle, covert tactics in conversations. In this paper, we propose Intent-Aware Prompting (IAP), a novel approach for detecting mental manipulations using large language models (LLMs), providing a deeper understanding of manipulative tactics by capturing the underlying intents of participants. Experimental results on the MentalManip dataset demonstrate superior effectiveness of IAP against other advanced prompting strategies. Notably, our approach substantially reduces false negatives, helping detect more instances of mental manipulation with minimal misjudgment of positive cases. The code of this paper is available at https://github.com/Anton-Jiayuan-MA/Manip-IAP.

Addressing the imminent shortfall of 10 million health workers by 2030, predominantly in Low- and Middle-Income Countries (LMICs), this paper introduces an innovative approach that harnesses the power of Large Language Models (LLMs) integrated with machine translation models. This solution is engineered to meet the unique needs of Community Health Workers (CHWs), overcoming language barriers, cultural sensitivities, and the limited availability of medical dialog datasets. I have crafted a model that not only boasts superior translation capabilities but also undergoes rigorous fine-tuning on open-source datasets to ensure medical accuracy and is equipped with comprehensive safety features to counteract the risks of misinformation. Featuring a modular design, this approach is specifically structured for swift adaptation across various linguistic and cultural contexts, utilizing open-source components to significantly reduce healthcare operational costs. This strategic innovation markedly improves the accessibility and quality of healthcare services by providing CHWs with contextually appropriate medical knowledge and diagnostic tools. This paper highlights the transformative impact of this context-aware LLM, underscoring its crucial role in addressing the global healthcare workforce deficit and propelling forward healthcare outcomes in LMICs.

Lung cancer patients frequently experience breakthrough pain episodes, with up to 91% requiring timely intervention. To enable proactive pain management, we propose a hybrid machine learning and large language model pipeline that predicts pain episodes within 48 and 72 hours of hospitalization using both structured and unstructured electronic health record data. A retrospective cohort of 266 inpatients was analyzed, with features including demographics, tumor stage, vital signs, and WHO-tiered analgesic use. The machine learning module captured temporal medication trends, while the large language model interpreted ambiguous dosing records and free-text clinical notes. Integrating these modalities improved sensitivity and interpretability. Our framework achieved an accuracy of 0.874 (48h) and 0.917 (72h), with an improvement in sensitivity of 8.6% and 10.4% due to the augmentation of large language model. This hybrid approach offers a clinically interpretable and scalable tool for early pain episode forecasting, with potential to enhance treatment precision and optimize resource allocation in oncology care.

One well motivated explanation method for classifiers leverages counterfactuals which are hypothetical events identical to real observations in all aspects except for one categorical feature. Constructing such counterfactual poses specific challenges for texts, however, as some attribute values may not necessarily align with plausible real-world events. In this paper we propose a simple method for generating counterfactuals by intervening in the space of text representations which bypasses this limitation. We argue that our interventions are minimally disruptive and that they are theoretically sound as they align with counterfactuals as defined in Pearl's causal inference framework. To validate our method, we first conduct experiments on a synthetic dataset of counterfactuals, allowing for a direct comparison between classifier predictions based on ground truth counterfactuals (obtained through explicit text interventions) and our counterfactuals, derived through interventions in the representation space. Second, we study a real world scenario where our counterfactuals can be leveraged both for explaining a classifier and for bias mitigation.

Online misinformation has been a serious threat to public health and society. Social media users are known to reply to misinformation posts with counter-misinformation messages, which have been shown to be effective in curbing the spread of misinformation. This is called social correction. However, the characteristics of tweets that attract social correction versus those that do not remain unknown. To close the gap, we focus on answering the following two research questions: (1) ``Given a tweet, will it be countered by other users?'', and (2) ``If yes, what will be the magnitude of countering it?''. This exploration will help develop mechanisms to guide users' misinformation correction efforts and to measure disparity across users who get corrected. In this work, we first create a novel dataset with 690,047 pairs of misinformation tweets and counter-misinformation replies. Then, stratified analysis of tweet linguistic and engagement features as well as tweet posters' user attributes are conducted to illustrate the factors that are significant in determining whether a tweet will get countered. Finally, predictive classifiers are created to predict the likelihood of a misinformation tweet to get countered and the degree to which that tweet will be countered. The code and data is accessible on https://github.com/claws-lab/social-correction-twitter.

Mechanistic interpretability seeks to understand the internal mechanisms of machine learning models, where localization -- identifying the important model components -- is a key step. Activation patching, also known as causal tracing or interchange intervention, is a standard technique for this task (Vig et al., 2020), but the literature contains many variants with little consensus on the choice of hyperparameters or methodology. In this work, we systematically examine the impact of methodological details in activation patching, including evaluation metrics and corruption methods. In several settings of localization and circuit discovery in language models, we find that varying these hyperparameters could lead to disparate interpretability results. Backed by empirical observations, we give conceptual arguments for why certain metrics or methods may be preferred. Finally, we provide recommendations for the best practices of activation patching going forwards.

Observational studies require adjustment for confounding factors that are correlated with both the treatment and outcome. In the setting where the observed variables are tabular quantities such as average income in a neighborhood, tools have been developed for addressing such confounding. However, in many parts of the developing world, features about local communities may be scarce. In this context, satellite imagery can play an important role, serving as a proxy for the confounding variables otherwise unobserved. In this paper, we study confounder adjustment in this non-tabular setting, where patterns or objects found in satellite images contribute to the confounder bias. Using the evaluation of anti-poverty aid programs in Africa as our running example, we formalize the challenge of performing causal adjustment with such unstructured data -- what conditions are sufficient to identify causal effects, how to perform estimation, and how to quantify the ways in which certain aspects of the unstructured image object are most predictive of the treatment decision. Via simulation, we also explore the sensitivity of satellite image-based observational inference to image resolution and to misspecification of the image-associated confounder. Finally, we apply these tools in estimating the effect of anti-poverty interventions in African communities from satellite imagery.

Large Language Models (LLMs) can struggle to balance gullibility to misinformation and resistance to valid corrections in persuasive dialogues, a critical challenge for reliable deployment. We introduce DuET-PD (Dual Evaluation for Trust in Persuasive Dialogues), a framework evaluating multi-turn stance-change dynamics across dual dimensions: persuasion type (corrective/misleading) and domain (knowledge via MMLU-Pro, and safety via SALAD-Bench). We find that even a state-of-the-art model like GPT-4o achieves only 27.32% accuracy in MMLU-Pro under sustained misleading persuasions. Moreover, results reveal a concerning trend of increasing sycophancy in newer open-source models. To address this, we introduce Holistic DPO, a training approach balancing positive and negative persuasion examples. Unlike prompting or resist-only training, Holistic DPO enhances both robustness to misinformation and receptiveness to corrections, improving Llama-3.1-8B-Instruct's accuracy under misleading persuasion in safety contexts from 4.21% to 76.54%. These contributions offer a pathway to developing more reliable and adaptable LLMs for multi-turn dialogue. Code is available at https://github.com/Social-AI-Studio/DuET-PD.

Counterfactual explanations are attracting significant attention due to the flourishing applications of machine learning models in consequential domains. A counterfactual plan consists of multiple possibilities to modify a given instance so that the model's prediction will be altered. As the predictive model can be updated subject to the future arrival of new data, a counterfactual plan may become ineffective or infeasible with respect to the future values of the model parameters. In this work, we study the counterfactual plans under model uncertainty, in which the distribution of the model parameters is partially prescribed using only the first- and second-moment information. First, we propose an uncertainty quantification tool to compute the lower and upper bounds of the probability of validity for any given counterfactual plan. We then provide corrective methods to adjust the counterfactual plan to improve the validity measure. The numerical experiments validate our bounds and demonstrate that our correction increases the robustness of the counterfactual plans in different real-world datasets.

Avoiding synthesizing specific visual concepts is an essential challenge in responsible visual synthesis. However, the visual concept that needs to be avoided for responsible visual synthesis tends to be diverse, depending on the region, context, and usage scenarios. In this work, we formalize a new task, Open-vocabulary Responsible Visual Synthesis (ORES), where the synthesis model is able to avoid forbidden visual concepts while allowing users to input any desired content. To address this problem, we present a Two-stage Intervention (TIN) framework. By introducing 1) rewriting with learnable instruction through a large-scale language model (LLM) and 2) synthesizing with prompt intervention on a diffusion synthesis model, it can effectively synthesize images avoiding any concepts but following the user's query as much as possible. To evaluate on ORES, we provide a publicly available dataset, baseline models, and benchmark. Experimental results demonstrate the effectiveness of our method in reducing risks of image generation. Our work highlights the potential of LLMs in responsible visual synthesis. Our code and dataset is public available.

Large language models (LLMs) have performed well in providing general and extensive health suggestions in single-turn conversations, exemplified by systems such as ChatGPT, ChatGLM, ChatDoctor, DoctorGLM, and etc. However, the limited information provided by users during single turn results in inadequate personalization and targeting of the generated suggestions, which requires users to independently select the useful part. It is mainly caused by the missing ability to engage in multi-turn questioning. In real-world medical consultations, doctors usually employ a series of iterative inquiries to comprehend the patient's condition thoroughly, enabling them to provide effective and personalized suggestions subsequently, which can be defined as chain of questioning (CoQ) for LLMs. To improve the CoQ of LLMs, we propose BianQue, a ChatGLM-based LLM finetuned with the self-constructed health conversation dataset BianQueCorpus that is consist of multiple turns of questioning and health suggestions polished by ChatGPT. Experimental results demonstrate that the proposed BianQue can simultaneously balance the capabilities of both questioning and health suggestions, which will help promote the research and application of LLMs in the field of proactive health.

Conversational agents are increasingly used to address emotional needs on top of information needs. One use case of increasing interest are counselling-style mental health and behaviour change interventions, with large language model (LLM)-based approaches becoming more popular. Research in this context so far has been largely system-focused, foregoing the aspect of user behaviour and the impact this can have on LLM-generated texts. To address this issue, we share a dataset containing text-based user interactions related to behaviour change with two GPT-4-based conversational agents collected in a preregistered user study. This dataset includes conversation data, user language analysis, perception measures, and user feedback for LLM-generated turns, and can offer valuable insights to inform the design of such systems based on real interactions.

Ensuring that online discussions are civil and productive is a major challenge for social media platforms. Such platforms usually rely both on users and on automated detection tools to flag inappropriate arguments of other users, which moderators then review. However, this kind of post-hoc moderation is expensive and time-consuming, and moderators are often overwhelmed by the amount and severity of flagged content. Instead, a promising alternative is to prevent negative behavior during content creation. This paper studies how inappropriate language in arguments can be computationally mitigated. We propose a reinforcement learning-based rewriting approach that balances content preservation and appropriateness based on existing classifiers, prompting an instruction-finetuned large language model (LLM) as our initial policy. Unlike related style transfer tasks, rewriting inappropriate arguments allows deleting and adding content permanently. It is therefore tackled on document level rather than sentence level. We evaluate different weighting schemes for the reward function in both absolute and relative human assessment studies. Systematic experiments on non-parallel data provide evidence that our approach can mitigate the inappropriateness of arguments while largely preserving their content. It significantly outperforms competitive baselines, including few-shot learning, prompting, and humans.

In industry NLP application, our manually labeled data has a certain number of noisy data. We present a simple method to find the noisy data and relabel them manually, meanwhile we collect the correction information. Then we present novel method to incorporate the human correction information into deep learning model. Human know how to correct noisy data. So the correction information can be inject into deep learning model. We do the experiment on our own text classification dataset, which is manually labeled, because we need to relabel the noisy data in our dataset for our industry application. The experiment result shows that our learn-on-correction method improve the classification accuracy from 91.7% to 92.5% in test dataset. The 91.7% accuracy is trained on the corrected dataset, which improve the baseline from 83.3% to 91.7% in test dataset. The accuracy under human evaluation achieves more than 97%.

Recent work in interpretability shows that large language models (LLMs) can be adapted for new tasks in a learning-free way: it is possible to intervene on LLM representations to elicit desired behaviors for alignment. For instance, adding certain bias vectors to the outputs of certain attention heads is reported to boost the truthfulness of models. In this work, we show that localized fine-tuning serves as an effective alternative to such representation intervention methods. We introduce a framework called Localized Fine-Tuning on LLM Representations (LoFiT), which identifies a subset of attention heads that are most important for learning a specific task, then trains offset vectors to add to the model's hidden representations at those selected heads. LoFiT localizes to a sparse set of heads (3%) and learns the offset vectors from limited training data, comparable to the settings used for representation intervention. For truthfulness and reasoning tasks, we find that LoFiT's intervention vectors are more effective for LLM adaptation than vectors from representation intervention methods such as Inference-time Intervention. We also find that the localization step is important: selecting a task-specific set of attention heads can lead to higher performance than intervening on heads selected for a different task. Finally, for the tasks we study, LoFiT achieves comparable performance to other parameter-efficient fine-tuning methods such as LoRA, despite modifying 20x-200x fewer parameters than these methods.

We test whether Large Language Models (LLMs) can be used to simulate human participants in social-science studies. To do this, we run replications of 14 studies from the Many Labs 2 replication project with OpenAI's text-davinci-003 model, colloquially known as GPT3.5. Based on our pre-registered analyses, we find that among the eight studies we could analyse, our GPT sample replicated 37.5% of the original results and 37.5% of the Many Labs 2 results. However, we were unable to analyse the remaining six studies due to an unexpected phenomenon we call the "correct answer" effect. Different runs of GPT3.5 answered nuanced questions probing political orientation, economic preference, judgement, and moral philosophy with zero or near-zero variation in responses: with the supposedly "correct answer." In one exploratory follow-up study, we found that a "correct answer" was robust to changing the demographic details that precede the prompt. In another, we found that most but not all "correct answers" were robust to changing the order of answer choices. One of our most striking findings occurred in our replication of the Moral Foundations Theory survey results, where we found GPT3.5 identifying as a political conservative in 99.6% of the cases, and as a liberal in 99.3% of the cases in the reverse-order condition. However, both self-reported 'GPT conservatives' and 'GPT liberals' showed right-leaning moral foundations. Our results cast doubts on the validity of using LLMs as a general replacement for human participants in the social sciences. Our results also raise concerns that a hypothetical AI-led future may be subject to a diminished diversity-of-thought.

We employ an audit design to investigate biases in state-of-the-art large language models, including GPT-4. In our study, we prompt the models for advice involving a named individual across a variety of scenarios, such as during car purchase negotiations or election outcome predictions. We find that the advice systematically disadvantages names that are commonly associated with racial minorities and women. Names associated with Black women receive the least advantageous outcomes. The biases are consistent across 42 prompt templates and several models, indicating a systemic issue rather than isolated incidents. While providing numerical, decision-relevant anchors in the prompt can successfully counteract the biases, qualitative details have inconsistent effects and may even increase disparities. Our findings underscore the importance of conducting audits at the point of LLM deployment and implementation to mitigate their potential for harm against marginalized communities.

Understanding and manipulating the causal generation mechanisms in language models is essential for controlling their behavior. Previous work has primarily relied on techniques such as representation surgery -- e.g., model ablations or manipulation of linear subspaces tied to specific concepts -- to intervene on these models. To understand the impact of interventions precisely, it is useful to examine counterfactuals -- e.g., how a given sentence would have appeared had it been generated by the model following a specific intervention. We highlight that counterfactual reasoning is conceptually distinct from interventions, as articulated in Pearl's causal hierarchy. Based on this observation, we propose a framework for generating true string counterfactuals by reformulating language models as Generalized Structural-equation. Models using the Gumbel-max trick. This allows us to model the joint distribution over original strings and their counterfactuals resulting from the same instantiation of the sampling noise. We develop an algorithm based on hindsight Gumbel sampling that allows us to infer the latent noise variables and generate counterfactuals of observed strings. Our experiments demonstrate that the approach produces meaningful counterfactuals while at the same time showing that commonly used intervention techniques have considerable undesired side effects.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.

Preference optimization methods typically begin training with a well-trained SFT model as a reference model. In RLHF and DPO, a regularization term is used during the preference optimization process to prevent the policy model from deviating too far from the reference model's distribution, thereby avoiding the generation of anomalous responses. When the reference model is already well-aligned with the given data or only requires slight adjustments, this approach can produce a well-aligned model. However, if the reference model is not aligned with the given data and requires significant deviation from its current state, a regularization term may actually hinder the model alignment. In this study, we propose Modulated Intervention Preference Optimization (MIPO) to address this issue. MIPO modulates the degree of intervention from the reference model based on how well the given data is aligned with it. If the data is well-aligned, the intervention is increased to prevent the policy model from diverging significantly from reference model. Conversely, if the alignment is poor, the interference is reduced to facilitate more extensive training. We compare the performance of MIPO and DPO using Mistral-7B and Llama3-8B in Alpaca Eval 2.0 and MT-Bench. The experimental results demonstrate that MIPO consistently outperforms DPO across various evaluation scenarios.

Organizations cannot address demographic disparities that they cannot see. Recent research on machine learning and fairness has emphasized that awareness of sensitive attributes, such as race and sex, is critical to the development of interventions. However, on the ground, the existence of these data cannot be taken for granted. This paper uses the domains of employment, credit, and healthcare in the United States to surface conditions that have shaped the availability of sensitive attribute data. For each domain, we describe how and when private companies collect or infer sensitive attribute data for antidiscrimination purposes. An inconsistent story emerges: Some companies are required by law to collect sensitive attribute data, while others are prohibited from doing so. Still others, in the absence of legal mandates, have determined that collection and imputation of these data are appropriate to address disparities. This story has important implications for fairness research and its future applications. If companies that mediate access to life opportunities are unable or hesitant to collect or infer sensitive attribute data, then proposed techniques to detect and mitigate bias in machine learning models might never be implemented outside the lab. We conclude that today's legal requirements and corporate practices, while highly inconsistent across domains, offer lessons for how to approach the collection and inference of sensitive data in appropriate circumstances. We urge stakeholders, including machine learning practitioners, to actively help chart a path forward that takes both policy goals and technical needs into account.

Diffusion language models are structurally well-suited for iterative error correction, as their non-causal denoising dynamics allow arbitrary positions in a sequence to be revised. However, standard masked diffusion language model (MDLM) training fails to reliably induce this behavior, as models often cannot identify unreliable tokens in a complete input, rendering confidence-guided refinement ineffective. We study corrective behavior in diffusion language models, defined as the ability to assign lower confidence to incorrect tokens and iteratively refine them while preserving correct content. We show that this capability is not induced by conventional masked diffusion objectives and propose a correction-oriented post-training principle that explicitly supervises visible incorrect tokens, enabling error-aware confidence and targeted refinement. To evaluate corrective behavior, we introduce the Code Revision Benchmark (CRB), a controllable and executable benchmark for assessing error localization and in-place correction. Experiments on code revision tasks and controlled settings demonstrate that models trained with our approach substantially outperform standard MDLMs in correction scenarios, while also improving pure completion performance. Our code is publicly available at https://github.com/zhangshuibai/CDLM.

Background: Large language models (LLMs) are trained to follow directions, but this introduces a vulnerability to blindly comply with user requests even if they generate wrong information. In medicine, this could accelerate the generation of misinformation that impacts human well-being. Objectives/Methods: We analyzed compliance to requests to generate misleading content about medications in settings where models know the request is illogical. We investigated whether in-context directions and instruction-tuning of LLMs to prioritize logical reasoning over compliance reduced misinformation risk. Results: While all frontier LLMs complied with misinformation requests, both prompt-based and parameter-based approaches can improve the detection of logic flaws in requests and prevent the dissemination of medical misinformation. Conclusion: Shifting LLMs to prioritize logic over compliance could reduce risks of exploitation for medical misinformation.

Persuasion plays a pivotal role in a wide range of applications from health intervention to the promotion of social good. Persuasive chatbots can accelerate the positive effects of persuasion in such applications. Existing methods rely on fine-tuning persuasive chatbots with task-specific training data which is costly, if not infeasible, to collect. To address this issue, we propose a method to leverage the generalizability and inherent persuasive abilities of large language models (LLMs) in creating effective and truthful persuasive chatbot for any given domain in a zero-shot manner. Unlike previous studies which used pre-defined persuasion strategies, our method first uses an LLM to generate responses, then extracts the strategies used on the fly, and replaces any unsubstantiated claims in the response with retrieved facts supporting the strategies. We applied our chatbot, PersuaBot, to three significantly different domains needing persuasion skills: donation solicitation, recommendations, and health intervention. Our experiments on simulated and human conversations show that our zero-shot approach is more persuasive than prior work, while achieving factual accuracy surpassing state-of-the-art knowledge-oriented chatbots. Our study demonstrated that when persuasive chatbots are employed responsibly for social good, it is an enabler of positive individual and social change.

Objective: The reading level of health educational materials significantly influences the understandability and accessibility of the information, particularly for minoritized populations. Many patient educational resources surpass the reading level and complexity of widely accepted standards. There is a critical need for high-performing text simplification models in health information to enhance dissemination and literacy. This need is particularly acute in cancer education, where effective prevention and screening education can substantially reduce morbidity and mortality. Methods: We introduce Simplified Digestive Cancer (SimpleDC), a parallel corpus of cancer education materials tailored for health text simplification research, comprising educational content from the American Cancer Society, Centers for Disease Control and Prevention, and National Cancer Institute. Utilizing SimpleDC alongside the existing Med-EASi corpus, we explore Large Language Model (LLM)-based simplification methods, including fine-tuning, reinforcement learning (RL), reinforcement learning with human feedback (RLHF), domain adaptation, and prompt-based approaches. Our experimentation encompasses Llama 2 and GPT-4. A novel RLHF reward function is introduced, featuring a lightweight model adept at distinguishing between original and simplified texts, thereby enhancing the model's effectiveness with unlabeled data. Results: Fine-tuned Llama 2 models demonstrated high performance across various metrics. Our innovative RLHF reward function surpassed existing RL text simplification reward functions in effectiveness. The results underscore that RL/RLHF can augment fine-tuning, facilitating model training on unlabeled text and improving performance.

There is a strong association between the quality of the writing in a resume for new labor market entrants and whether those entrants are ultimately hired. We show that this relationship is, at least partially, causal: a field experiment in an online labor market was conducted with nearly half a million jobseekers in which a treated group received algorithmic writing assistance. Treated jobseekers experienced an 8% increase in the probability of getting hired. Contrary to concerns that the assistance is taking away a valuable signal, we find no evidence that employers were less satisfied. We present a model in which better writing is not a signal of ability but helps employers ascertain ability, which rationalizes our findings.

Machine learning models trained on Earth observation data, such as satellite imagery, have demonstrated significant promise in predicting household-level wealth indices, enabling the creation of high-resolution wealth maps that can be leveraged across multiple causal trials. However, because standard training objectives prioritize overall predictive accuracy, these predictions inherently suffer from shrinkage toward the mean, leading to attenuated estimates of causal treatment effects and limiting their utility in policy. Existing debiasing methods, such as Prediction-Powered Inference, can handle this attenuation bias but require additional fresh ground-truth data at the downstream stage of causal inference, which restricts their applicability in data-scarce environments. Here, we introduce and evaluate two correction methods -- linear calibration correction and Tweedie's correction -- that substantially reduce prediction bias without relying on newly collected labeled data. Linear calibration corrects bias through a straightforward linear transformation derived from held-out calibration data, whereas Tweedie's correction leverages empirical Bayes principles to directly address shrinkage-induced biases by exploiting score functions derived from the model's learning patterns. Through analytical exercises and experiments using Demographic and Health Survey data, we demonstrate that the proposed methods meet or outperform existing approaches that either require (a) adjustments to training pipelines or (b) additional labeled data. These approaches may represent a promising avenue for improving the reliability of causal inference when direct outcome measures are limited or unavailable, enabling a "one map, many trials" paradigm where a single upstream data creation team produces predictions usable by many downstream teams across diverse ML pipelines.

Concept bottleneck models (CBMs) are a class of interpretable neural network models that predict the target response of a given input based on its high-level concepts. Unlike the standard end-to-end models, CBMs enable domain experts to intervene on the predicted concepts and rectify any mistakes at test time, so that more accurate task predictions can be made at the end. While such intervenability provides a powerful avenue of control, many aspects of the intervention procedure remain rather unexplored. In this work, we develop various ways of selecting intervening concepts to improve the intervention effectiveness and conduct an array of in-depth analyses as to how they evolve under different circumstances. Specifically, we find that an informed intervention strategy can reduce the task error more than ten times compared to the current baseline under the same amount of intervention counts in realistic settings, and yet, this can vary quite significantly when taking into account different intervention granularity. We verify our findings through comprehensive evaluations, not only on the standard real datasets, but also on synthetic datasets that we generate based on a set of different causal graphs. We further discover some major pitfalls of the current practices which, without a proper addressing, raise concerns on reliability and fairness of the intervention procedure.

Cognitive Restructuring (CR) is a psychotherapeutic process aimed at identifying and restructuring an individual's negative thoughts, arising from mental health challenges, into more helpful and positive ones via multi-turn dialogues. Clinician shortage and stigma urge the development of human-LLM interactive psychotherapy for CR. Yet, existing efforts implement CR via simple text rewriting, fixed-pattern dialogues, or a one-shot CR workflow, failing to align with the psychotherapeutic process for effective CR. To address this gap, we propose CRDial, a novel framework for CR, which creates multi-turn dialogues with specifically designed identification and restructuring stages of negative thoughts, integrates sentence-level supportive conversation strategies, and adopts a multi-channel loop mechanism to enable iterative CR. With CRDial, we distill Crisp, a large-scale and high-quality bilingual dialogue dataset, from LLM. We then train Crispers, Crisp-based conversational LLMs for CR, at 7B and 14B scales. Extensive human studies show the superiority of Crispers in pointwise, pairwise, and intervention evaluations.

Access to the right evidence does not guarantee that large language models (LLMs) will reason with it correctly. This gap between retrieval and reasoning is especially concerning in clinical settings, where outputs must align with structured protocols. We study this gap using Written Exposure Therapy (WET) guidelines as a testbed. In evaluating model responses to curated clinician-vetted questions, we find that errors persist even when authoritative passages are provided. To address this, we propose an evaluation framework that measures accuracy, consistency, and fidelity of reasoning. Our results highlight both the potential and the risks: retrieval-augmented generation (RAG) can constrain outputs, but safe deployment requires assessing reasoning as rigorously as retrieval.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Representation engineering methods have recently shown promise for enabling efficient steering of model behavior. However, evaluation pipelines for these methods have primarily relied on subjective demonstrations, instead of quantitative, objective metrics. We aim to take a step towards addressing this issue by advocating for four properties missing from current evaluations: (i) contexts sufficiently similar to downstream tasks should be used for assessing intervention quality; (ii) model likelihoods should be accounted for; (iii) evaluations should allow for standardized comparisons across different target behaviors; and (iv) baseline comparisons should be offered. We introduce an evaluation pipeline grounded in these criteria, offering both a quantitative and visual analysis of how effectively a given method works. We use this pipeline to evaluate two representation engineering methods on how effectively they can steer behaviors such as truthfulness and corrigibility, finding that some interventions are less effective than previously reported.

Recent work has explored how to train machine learning models which do not discriminate against any subgroup of the population as determined by sensitive attributes such as gender or race. To avoid disparate treatment, sensitive attributes should not be considered. On the other hand, in order to avoid disparate impact, sensitive attributes must be examined, e.g., in order to learn a fair model, or to check if a given model is fair. We introduce methods from secure multi-party computation which allow us to avoid both. By encrypting sensitive attributes, we show how an outcome-based fair model may be learned, checked, or have its outputs verified and held to account, without users revealing their sensitive attributes.