Rewarding Doubt: A Reinforcement Learning Approach to Confidence Calibration of Large Language Models

A safe and trustworthy use of Large Language Models (LLMs) requires an accurate expression of confidence in their answers. We introduce a novel Reinforcement Learning (RL) approach for LLM calibration that fine-tunes LLMs to elicit calibrated confidence estimations in their answers to factual questions. We model the problem as a betting game where the model predicts a confidence score together with every answer, and design a reward function that penalizes both over and under-confidence. We prove that under our reward design an optimal policy would result in a perfectly calibrated confidence estimation. Our experiments demonstrate significantly improved confidence calibration and generalization to new tasks without re-training, indicating that our approach teaches a general confidence awareness. This approach enables the training of inherently calibrated LLMs.

MM-OR: A Large Multimodal Operating Room Dataset for Semantic Understanding of High-Intensity Surgical Environments

Operating rooms (ORs) are complex, high-stakes environments requiring precise understanding of interactions among medical staff, tools, and equipment for enhancing surgical assistance, situational awareness, and patient safety. Current datasets fall short in scale, realism and do not capture the multimodal nature of OR scenes, limiting progress in OR modeling. To this end, we introduce MM-OR, a realistic and large-scale multimodal spatiotemporal OR dataset, and the first dataset to enable multimodal scene graph generation. MM-OR captures comprehensive OR scenes containing RGB-D data, detail views, audio, speech transcripts, robotic logs, and tracking data and is annotated with panoptic segmentations, semantic scene graphs, and downstream task labels. Further, we propose MM2SG, the first multimodal large vision-language model for scene graph generation, and through extensive experiments, demonstrate its ability to effectively leverage multimodal inputs. Together, MM-OR and MM2SG establish a new benchmark for holistic OR understanding, and open the path towards multimodal scene analysis in complex, high-stakes environments. Our code, and data is available at https://github.com/egeozsoy/MM-OR.

MAGDA: Multi-agent guideline-driven diagnostic assistance

In emergency departments, rural hospitals, or clinics in less developed regions, clinicians often lack fast image analysis by trained radiologists, which can have a detrimental effect on patients' healthcare. Large Language Models (LLMs) have the potential to alleviate some pressure from these clinicians by providing insights that can help them in their decision-making. While these LLMs achieve high test results on medical exams showcasing their great theoretical medical knowledge, they tend not to follow medical guidelines. In this work, we introduce a new approach for zero-shot guideline-driven decision support. We model a system of multiple LLM agents augmented with a contrastive vision-language model that collaborate to reach a patient diagnosis. After providing the agents with simple diagnostic guidelines, they will synthesize prompts and screen the image for findings following these guidelines. Finally, they provide understandable chain-of-thought reasoning for their diagnosis, which is then self-refined to consider inter-dependencies between diseases. As our method is zero-shot, it is adaptable to settings with rare diseases, where training data is limited, but expert-crafted disease descriptions are available. We evaluate our method on two chest X-ray datasets, CheXpert and ChestX-ray 14 Longtail, showcasing performance improvement over existing zero-shot methods and generalizability to rare diseases.

U-GAT: Multimodal Graph Attention Network for COVID-19 Outcome Prediction

During the first wave of COVID-19, hospitals were overwhelmed with the high number of admitted patients. An accurate prediction of the most likely individual disease progression can improve the planning of limited resources and finding the optimal treatment for patients. However, when dealing with a newly emerging disease such as COVID-19, the impact of patient- and disease-specific factors (e.g. body weight or known co-morbidities) on the immediate course of disease is by and large unknown. In the case of COVID-19, the need for intensive care unit (ICU) admission of pneumonia patients is often determined only by acute indicators such as vital signs (e.g. breathing rate, blood oxygen levels), whereas statistical analysis and decision support systems that integrate all of the available data could enable an earlier prognosis. To this end, we propose a holistic graph-based approach combining both imaging and non-imaging information. Specifically, we introduce a multimodal similarity metric to build a population graph for clustering patients and an image-based end-to-end Graph Attention Network to process this graph and predict the COVID-19 patient outcomes: admission to ICU, need for ventilation and mortality. Additionally, the network segments chest CT images as an auxiliary task and extracts image features and radiomics for feature fusion with the available metadata. Results on a dataset collected in Klinikum rechts der Isar in Munich, Germany show that our approach outperforms single modality and non-graph baselines. Moreover, our clustering and graph attention allow for increased understanding of the patient relationships within the population graph and provide insight into the network's decision-making process.

Decision Support for Intoxication Prediction Using Graph Convolutional Networks

Every day, poison control centers (PCC) are called for immediate classification and treatment recommendations if an acute intoxication is suspected. Due to the time-sensitive nature of these cases, doctors are required to propose a correct diagnosis and intervention within a minimal time frame. Usually the toxin is known and recommendations can be made accordingly. However, in challenging cases only symptoms are mentioned and doctors have to rely on their clinical experience. Medical experts and our analyses of a regional dataset of intoxication records provide evidence that this is challenging, since occurring symptoms may not always match the textbook description due to regional distinctions, inter-rater variance, and institutional workflow. Computer-aided diagnosis (CADx) can provide decision support, but approaches so far do not consider additional information of the reported cases like age or gender, despite their potential value towards a correct diagnosis. In this work, we propose a new machine learning based CADx method which fuses symptoms and meta information of the patients using graph convolutional networks. We further propose a novel symptom matching method that allows the effective incorporation of prior knowledge into the learning process and evidently stabilizes the poison prediction. We validate our method against 10 medical doctors with different experience diagnosing intoxication cases for 10 different toxins from the PCC in Munich and show our method's superiority in performance for poison prediction.