FinCriticalED: A Visual Benchmark for Financial Fact-Level OCR Evaluation

We introduce FinCriticalED (Financial Critical Error Detection), a visual benchmark for evaluating OCR and vision language models on financial documents at the fact level. Financial documents contain visually dense and table heavy layouts where numerical and temporal information is tightly coupled with structure. In high stakes settings, small OCR mistakes such as sign inversion or shifted dates can lead to materially different interpretations, while traditional OCR metrics like ROUGE and edit distance capture only surface level text similarity. \ficriticaled provides 500 image-HTML pairs with expert annotated financial facts covering over seven hundred numerical and temporal facts. It introduces three key contributions. First, it establishes the first fact level evaluation benchmark for financial document understanding, shifting evaluation from lexical overlap to domain critical factual correctness. Second, all annotations are created and verified by financial experts with strict quality control over signs, magnitudes, and temporal expressions. Third, we develop an LLM-as-Judge evaluation pipeline that performs structured fact extraction and contextual verification for visually complex financial documents. We benchmark OCR systems, open source vision language models, and proprietary models on FinCriticalED. Results show that although the strongest proprietary models achieve the highest factual accuracy, substantial errors remain in visually intricate numerical and temporal contexts. Through quantitative evaluation and expert case studies, FinCriticalED provides a rigorous foundation for advancing visual factual precision in financial and other precision critical domains.

MeCaMIL: Causality-Aware Multiple Instance Learning for Fair and Interpretable Whole Slide Image Diagnosis

Multiple instance learning (MIL) has emerged as the dominant paradigm for whole slide image (WSI) analysis in computational pathology, achieving strong diagnostic performance through patch-level feature aggregation. However, existing MIL methods face critical limitations: (1) they rely on attention mechanisms that lack causal interpretability, and (2) they fail to integrate patient demographics (age, gender, race), leading to fairness concerns across diverse populations. These shortcomings hinder clinical translation, where algorithmic bias can exacerbate health disparities. We introduce \textbf{MeCaMIL}, a causality-aware MIL framework that explicitly models demographic confounders through structured causal graphs. Unlike prior approaches treating demographics as auxiliary features, MeCaMIL employs principled causal inference -- leveraging do-calculus and collider structures -- to disentangle disease-relevant signals from spurious demographic correlations. Extensive evaluation on three benchmarks demonstrates state-of-the-art performance across CAMELYON16 (ACC/AUC/F1: 0.939/0.983/0.946), TCGA-Lung (0.935/0.979/0.931), and TCGA-Multi (0.977/0.993/0.970, five cancer types). Critically, MeCaMIL achieves superior fairness -- demographic disparity variance drops by over 65% relative reduction on average across attributes, with notable improvements for underserved populations. The framework generalizes to survival prediction (mean C-index: 0.653, +0.017 over best baseline across five cancer types). Ablation studies confirm causal graph structure is essential -- alternative designs yield 0.048 lower accuracy and 4.2x times worse fairness. These results establish MeCaMIL as a principled framework for fair, interpretable, and clinically actionable AI in digital pathology. Code will be released upon acceptance.

Two-Stage Decoupling Framework for Variable-Length Glaucoma Prognosis

Glaucoma is one of the leading causes of irreversible blindness worldwide. Glaucoma prognosis is essential for identifying at-risk patients and enabling timely intervention to prevent blindness. Many existing approaches rely on historical sequential data but are constrained by fixed-length inputs, limiting their flexibility. Additionally, traditional glaucoma prognosis methods often employ end-to-end models, which struggle with the limited size of glaucoma datasets. To address these challenges, we propose a Two-Stage Decoupling Framework (TSDF) for variable-length glaucoma prognosis. In the first stage, we employ a feature representation module that leverages self-supervised learning to aggregate multiple glaucoma datasets for training, disregarding differences in their supervisory information. This approach enables datasets of varying sizes to learn better feature representations. In the second stage, we introduce a temporal aggregation module that incorporates an attention-based mechanism to process sequential inputs of varying lengths, ensuring flexible and efficient utilization of all available data. This design significantly enhances model performance while maintaining a compact parameter size. Extensive experiments on two benchmark glaucoma datasets:the Ocular Hypertension Treatment Study (OHTS) and the Glaucoma Real-world Appraisal Progression Ensemble (GRAPE),which differ significantly in scale and clinical settings,demonstrate the effectiveness and robustness of our approach.

Data-Efficient Biomedical In-Context Learning: A Diversity-Enhanced Submodular Perspective

Recent progress in large language models (LLMs) has leveraged their in-context learning (ICL) abilities to enable quick adaptation to unseen biomedical NLP tasks. By incorporating only a few input-output examples into prompts, LLMs can rapidly perform these new tasks. While the impact of these demonstrations on LLM performance has been extensively studied, most existing approaches prioritize representativeness over diversity when selecting examples from large corpora. To address this gap, we propose Dual-Div, a diversity-enhanced data-efficient framework for demonstration selection in biomedical ICL. Dual-Div employs a two-stage retrieval and ranking process: First, it identifies a limited set of candidate examples from a corpus by optimizing both representativeness and diversity (with optional annotation for unlabeled data). Second, it ranks these candidates against test queries to select the most relevant and non-redundant demonstrations. Evaluated on three biomedical NLP tasks (named entity recognition (NER), relation extraction (RE), and text classification (TC)) using LLaMA 3.1 and Qwen 2.5 for inference, along with three retrievers (BGE-Large, BMRetriever, MedCPT), Dual-Div consistently outperforms baselines-achieving up to 5% higher macro-F1 scores-while demonstrating robustness to prompt permutations and class imbalance. Our findings establish that diversity in initial retrieval is more critical than ranking-stage optimization, and limiting demonstrations to 3-5 examples maximizes performance efficiency.

CXR-LT 2024: A MICCAI challenge on long-tailed, multi-label, and zero-shot disease classification from chest X-ray

The CXR-LT series is a community-driven initiative designed to enhance lung disease classification using chest X-rays (CXR). It tackles challenges in open long-tailed lung disease classification and enhances the measurability of state-of-the-art techniques. The first event, CXR-LT 2023, aimed to achieve these goals by providing high-quality benchmark CXR data for model development and conducting comprehensive evaluations to identify ongoing issues impacting lung disease classification performance. Building on the success of CXR-LT 2023, the CXR-LT 2024 expands the dataset to 377,110 chest X-rays (CXRs) and 45 disease labels, including 19 new rare disease findings. It also introduces a new focus on zero-shot learning to address limitations identified in the previous event. Specifically, CXR-LT 2024 features three tasks: (i) long-tailed classification on a large, noisy test set, (ii) long-tailed classification on a manually annotated "gold standard" subset, and (iii) zero-shot generalization to five previously unseen disease findings. This paper provides an overview of CXR-LT 2024, detailing the data curation process and consolidating state-of-the-art solutions, including the use of multimodal models for rare disease detection, advanced generative approaches to handle noisy labels, and zero-shot learning strategies for unseen diseases. Additionally, the expanded dataset enhances disease coverage to better represent real-world clinical settings, offering a valuable resource for future research. By synthesizing the insights and innovations of participating teams, we aim to advance the development of clinically realistic and generalizable diagnostic models for chest radiography.

Uncertainty-Aware Large Language Models for Explainable Disease Diagnosis

Explainable disease diagnosis, which leverages patient information (e.g., signs and symptoms) and computational models to generate probable diagnoses and reasonings, offers clear clinical values. However, when clinical notes encompass insufficient evidence for a definite diagnosis, such as the absence of definitive symptoms, diagnostic uncertainty usually arises, increasing the risk of misdiagnosis and adverse outcomes. Although explicitly identifying and explaining diagnostic uncertainties is essential for trustworthy diagnostic systems, it remains under-explored. To fill this gap, we introduce ConfiDx, an uncertainty-aware large language model (LLM) created by fine-tuning open-source LLMs with diagnostic criteria. We formalized the task and assembled richly annotated datasets that capture varying degrees of diagnostic ambiguity. Evaluating ConfiDx on real-world datasets demonstrated that it excelled in identifying diagnostic uncertainties, achieving superior diagnostic performance, and generating trustworthy explanations for diagnoses and uncertainties. To our knowledge, this is the first study to jointly address diagnostic uncertainty recognition and explanation, substantially enhancing the reliability of automatic diagnostic systems.

FLAG-Trader: Fusion LLM-Agent with Gradient-based Reinforcement Learning for Financial Trading

Large language models (LLMs) fine-tuned on multimodal financial data have demonstrated impressive reasoning capabilities in various financial tasks. However, they often struggle with multi-step, goal-oriented scenarios in interactive financial markets, such as trading, where complex agentic approaches are required to improve decision-making. To address this, we propose \textsc{FLAG-Trader}, a unified architecture integrating linguistic processing (via LLMs) with gradient-driven reinforcement learning (RL) policy optimization, in which a partially fine-tuned LLM acts as the policy network, leveraging pre-trained knowledge while adapting to the financial domain through parameter-efficient fine-tuning. Through policy gradient optimization driven by trading rewards, our framework not only enhances LLM performance in trading but also improves results on other financial-domain tasks. We present extensive empirical evidence to validate these enhancements.

Continually Evolved Multimodal Foundation Models for Cancer Prognosis

Cancer prognosis is a critical task that involves predicting patient outcomes and survival rates. To enhance prediction accuracy, previous studies have integrated diverse data modalities, such as clinical notes, medical images, and genomic data, leveraging their complementary information. However, existing approaches face two major limitations. First, they struggle to incorporate newly arrived data with varying distributions into training, such as patient records from different hospitals, thus rendering sub-optimal generalizability and limited utility in real-world applications. Second, most multimodal integration methods rely on simplistic concatenation or task-specific pipelines, which fail to capture the complex interdependencies across modalities. To address these, we propose a continually evolving multi-modal foundation model. Extensive experiments on the TCGA dataset demonstrate the effectiveness of our approach, highlighting its potential to advance cancer prognosis by enabling robust and adaptive multimodal integration.

Large Language Models for Disease Diagnosis: A Scoping Review

Automatic disease diagnosis has become increasingly valuable in clinical practice. The advent of large language models (LLMs) has catalyzed a paradigm shift in artificial intelligence, with growing evidence supporting the efficacy of LLMs in diagnostic tasks. Despite the growing attention in this field, many critical research questions remain under-explored. For instance, what diseases and LLM techniques have been investigated for diagnostic tasks? How can suitable LLM techniques and evaluation methods be selected for clinical decision-making? To answer these questions, we performed a comprehensive analysis of LLM-based methods for disease diagnosis. This scoping review examined the types of diseases, associated organ systems, relevant clinical data, LLM techniques, and evaluation methods reported in existing studies. Furthermore, we offered guidelines for data preprocessing and the selection of appropriate LLM techniques and evaluation strategies for diagnostic tasks. We also assessed the limitations of current research and delineated the challenges and future directions in this research field. In summary, our review outlined a blueprint for LLM-based disease diagnosis, helping to streamline and guide future research endeavors.

Interpretable Differential Diagnosis with Dual-Inference Large Language Models

Methodological advancements to automate the generation of differential diagnosis (DDx) to predict a list of potential diseases as differentials given patients' symptom descriptions are critical to clinical reasoning and applications such as decision support. However, providing reasoning or interpretation for these differential diagnoses is more meaningful. Fortunately, large language models (LLMs) possess powerful language processing abilities and have been proven effective in various related tasks. Motivated by this potential, we investigate the use of LLMs for interpretable DDx. First, we develop a new DDx dataset with expert-derived interpretation on 570 public clinical notes. Second, we propose a novel framework, named Dual-Inf, that enables LLMs to conduct bidirectional inference for interpretation. Both human and automated evaluation demonstrate the effectiveness of Dual-Inf in predicting differentials and diagnosis explanations. Specifically, the performance improvement of Dual-Inf over the baseline methods exceeds 32% w.r.t. BERTScore in DDx interpretation. Furthermore, experiments verify that Dual-Inf (1) makes fewer errors in interpretation, (2) has great generalizability, (3) is promising for rare disease diagnosis and explanation.