ReflecTool: Towards Reflection-Aware Tool-Augmented Clinical Agents

Large Language Models (LLMs) have shown promising potential in the medical domain, assisting with tasks like clinical note generation and patient communication. However, current LLMs are limited to text-based communication, hindering their ability to interact with diverse forms of information in clinical environments. Despite clinical agents succeeding in diverse signal interaction, they are oriented to a single clinical scenario and hence fail for broader applications. To evaluate clinical agents holistically, we propose ClinicalAgent Bench~(CAB), a comprehensive medical agent benchmark consisting of 18 tasks across five key realistic clinical dimensions. Building on this, we introduce ReflecTool, a novel framework that excels at utilizing domain-specific tools within two stages. The first optimization stage progressively enlarges a long-term memory by saving successful solving processes and tool-wise experience of agents in a tiny pre-defined training set. In the following inference stage, ReflecTool can search for supportive successful demonstrations from already built long-term memory to guide the tool selection strategy, and a verifier improves the tool usage according to the tool-wise experience with two verification methods--iterative refinement and candidate selection. Extensive experiments on ClinicalAgent Benchmark demonstrate that ReflecTool surpasses the pure LLMs with more than 10 points and the well-established agent-based methods with 3 points, highlighting its adaptability and effectiveness in solving complex clinical tasks.

Med-PMC: Medical Personalized Multi-modal Consultation with a Proactive Ask-First-Observe-Next Paradigm

The application of the Multi-modal Large Language Models (MLLMs) in medical clinical scenarios remains underexplored. Previous benchmarks only focus on the capacity of the MLLMs in medical visual question-answering (VQA) or report generation and fail to assess the performance of the MLLMs on complex clinical multi-modal tasks. In this paper, we propose a novel Medical Personalized Multi-modal Consultation (Med-PMC) paradigm to evaluate the clinical capacity of the MLLMs. Med-PMC builds a simulated clinical environment where the MLLMs are required to interact with a patient simulator to complete the multi-modal information-gathering and decision-making task. Specifically, the patient simulator is decorated with personalized actors to simulate diverse patients in real scenarios. We conduct extensive experiments to access 12 types of MLLMs, providing a comprehensive view of the MLLMs' clinical performance. We found that current MLLMs fail to gather multimodal information and show potential bias in the decision-making task when consulted with the personalized patient simulators. Further analysis demonstrates the effectiveness of Med-PMC, showing the potential to guide the development of robust and reliable clinical MLLMs. Code and data are available at https://github.com/LiuHC0428/Med-PMC.

Decoding Linguistic Representations of Human Brain

Language, as an information medium created by advanced organisms, has always been a concern of neuroscience regarding how it is represented in the brain. Decoding linguistic representations in the evoked brain has shown groundbreaking achievements, thanks to the rapid improvement of neuroimaging, medical technology, life sciences and artificial intelligence. In this work, we present a taxonomy of brain-to-language decoding of both textual and speech formats. This work integrates two types of research: neuroscience focusing on language understanding and deep learning-based brain decoding. Generating discernible language information from brain activity could not only help those with limited articulation, especially amyotrophic lateral sclerosis (ALS) patients but also open up a new way for the next generation's brain-computer interface (BCI). This article will help brain scientists and deep-learning researchers to gain a bird's eye view of fine-grained language perception, and thus facilitate their further investigation and research of neural process and language decoding.

MedCare: Advancing Medical LLMs through Decoupling Clinical Alignment and Knowledge Aggregation

Large language models (LLMs) have shown substantial progress in natural language understanding and generation, proving valuable especially in the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks, which can be categorized as knowledge-intensive tasks and alignment-required tasks. Previous approaches either ignore the latter task or focus on a minority of tasks and hence lose generalization. To address these drawbacks, we propose a progressive fine-tuning pipeline. This pipeline employs a Knowledge Aggregator and a Noise aggregator to encode diverse knowledge in the first stage and filter out detrimental information. In the second stage, we drop the Noise Aggregator to avoid the interference of suboptimal representation and leverage an additional alignment module optimized towards an orthogonal direction to the knowledge space to mitigate knowledge forgetting. Based on this two-stage paradigm, we proposed a Medical LLM through decoupling Clinical Alignment and Knowledge Aggregation (MedCare), which is designed to achieve state-of-the-art (SOTA) performance on over 20 medical tasks, as well as SOTA results on specific medical alignment tasks. Various model sizes of MedCare (1.8B, 7B, 14B) all demonstrate significant improvements over existing models with similar model sizes.

TAIA: Large Language Models are Out-of-Distribution Data Learners

Fine-tuning on task-specific question-answer pairs is a predominant method for enhancing the performance of instruction-tuned large language models (LLMs) on downstream tasks. However, in certain specialized domains, such as healthcare or harmless content generation, it is nearly impossible to obtain a large volume of high-quality data that matches the downstream distribution. To improve the performance of LLMs in data-scarce domains with domain-mismatched data, we re-evaluated the Transformer architecture and discovered that not all parameter updates during fine-tuning contribute positively to downstream performance. Our analysis reveals that within the self-attention and feed-forward networks, only the fine-tuned attention parameters are particularly beneficial when the training set's distribution does not fully align with the test set. Based on this insight, we propose an effective inference-time intervention method: \uline{T}raining \uline{A}ll parameters but \uline{I}nferring with only \uline{A}ttention (\trainallInfAttn). We empirically validate \trainallInfAttn using two general instruction-tuning datasets and evaluate it on seven downstream tasks involving math, reasoning, and knowledge understanding across LLMs of different parameter sizes and fine-tuning techniques. Our comprehensive experiments demonstrate that \trainallInfAttn achieves superior improvements compared to both the fully fine-tuned model and the base model in most scenarios, with significant performance gains. The high tolerance of \trainallInfAttn to data mismatches makes it resistant to jailbreaking tuning and enhances specialized tasks using general data.

MING-MOE: Enhancing Medical Multi-Task Learning in Large Language Models with Sparse Mixture of Low-Rank Adapter Experts

Large language models like ChatGPT have shown substantial progress in natural language understanding and generation, proving valuable across various disciplines, including the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks which often require multi-task learning capabilities. Previous approaches, although beneficial, fall short in real-world applications because they necessitate task-specific annotations at inference time, limiting broader generalization. This paper introduces MING-MOE, a novel Mixture-of-Expert~(MOE)-based medical large language model designed to manage diverse and complex medical tasks without requiring task-specific annotations, thus enhancing its usability across extensive datasets. MING-MOE employs a Mixture of Low-Rank Adaptation (MoLoRA) technique, allowing for efficient parameter usage by maintaining base model parameters static while adapting through a minimal set of trainable parameters. We demonstrate that MING-MOE achieves state-of-the-art (SOTA) performance on over 20 medical tasks, illustrating a significant improvement over existing models. This approach not only extends the capabilities of medical language models but also improves inference efficiency.

Automatic Interactive Evaluation for Large Language Models with State Aware Patient Simulator

Large Language Models (LLMs) have demonstrated remarkable proficiency in human interactions, yet their application within the medical field remains insufficiently explored. Previous works mainly focus on the performance of medical knowledge with examinations, which is far from the realistic scenarios, falling short in assessing the abilities of LLMs on clinical tasks. In the quest to enhance the application of Large Language Models (LLMs) in healthcare, this paper introduces the Automated Interactive Evaluation (AIE) framework and the State-Aware Patient Simulator (SAPS), targeting the gap between traditional LLM evaluations and the nuanced demands of clinical practice. Unlike prior methods that rely on static medical knowledge assessments, AIE and SAPS provide a dynamic, realistic platform for assessing LLMs through multi-turn doctor-patient simulations. This approach offers a closer approximation to real clinical scenarios and allows for a detailed analysis of LLM behaviors in response to complex patient interactions. Our extensive experimental validation demonstrates the effectiveness of the AIE framework, with outcomes that align well with human evaluations, underscoring its potential to revolutionize medical LLM testing for improved healthcare delivery.

Leveraging Diverse Modeling Contexts with Collaborating Learning for Neural Machine Translation

Autoregressive (AR) and Non-autoregressive (NAR) models are two types of generative models for Neural Machine Translation (NMT). AR models predict tokens in a word-by-word manner and can effectively capture the distribution of real translations. NAR models predict tokens by extracting bidirectional contextual information which can improve the inference speed but they suffer from performance degradation. Previous works utilized AR models to enhance NAR models by reducing the training data's complexity or incorporating the global information into AR models by virtue of NAR models. However, those investigated methods only take advantage of the contextual information of a single type of model while neglecting the diversity in the contextual information that can be provided by different types of models. In this paper, we propose a novel generic collaborative learning method, DCMCL, where AR and NAR models are treated as collaborators instead of teachers and students. To hierarchically leverage the bilateral contextual information, token-level mutual learning and sequence-level contrastive learning are adopted between AR and NAR models. Extensive experiments on four widely used benchmarks show that the proposed DCMCL method can simultaneously improve both AR and NAR models with up to 1.38 and 2.98 BLEU scores respectively, and can also outperform the current best-unified model with up to 0.97 BLEU scores for both AR and NAR decoding.

MM-SAP: A Comprehensive Benchmark for Assessing Self-Awareness of Multimodal Large Language Models in Perception

Multimodal Large Language Models (MLLMs) have shown their remarkable abilities in visual perception and understanding recently. However, how to comprehensively evaluate the capabilities of MLLMs remains a challenge. Most of the existing benchmarks predominantly focus on assessing perception, cognition, and reasoning, neglecting the abilities of self-awareness, referring to the model's recognition of its own capability boundary. In our study, we focus on self-awareness in image perception and introduce the knowledge quadrant for MLLMs, which clearly defines the knowns and unknowns in perception. Based on this, we propose a novel benchmark specifically designed to evaluate the Self-Aware capabilities in Perception for MLLMs(MM-SAP). MM-SAP encompasses three distinct sub-datasets, each focusing on different aspects of self-awareness. We evaluated eight well-known MLLMs using MM-SAP, analyzing their self-awareness and providing detailed insights. Code and data are available at https://github.com/YHWmz/MM-SAP

An Automatic Evaluation Framework for Multi-turn Medical Consultations Capabilities of Large Language Models

Large language models (LLMs) have achieved significant success in interacting with human. However, recent studies have revealed that these models often suffer from hallucinations, leading to overly confident but incorrect judgments. This limits their application in the medical domain, where tasks require the utmost accuracy. This paper introduces an automated evaluation framework that assesses the practical capabilities of LLMs as virtual doctors during multi-turn consultations. Consultation tasks are designed to require LLMs to be aware of what they do not know, to inquire about missing medical information from patients, and to ultimately make diagnoses. To evaluate the performance of LLMs for these tasks, a benchmark is proposed by reformulating medical multiple-choice questions from the United States Medical Licensing Examinations (USMLE), and comprehensive evaluation metrics are developed and evaluated on three constructed test sets. A medical consultation training set is further constructed to improve the consultation ability of LLMs. The results of the experiments show that fine-tuning with the training set can alleviate hallucinations and improve LLMs' performance on the proposed benchmark. Extensive experiments and ablation studies are conducted to validate the effectiveness and robustness of the proposed framework.