Universal Model Routing for Efficient LLM Inference

Large language models' significant advances in capabilities are accompanied by significant increases in inference costs. Model routing is a simple technique for reducing inference cost, wherein one maintains a pool of candidate LLMs, and learns to route each prompt to the smallest feasible LLM. Existing works focus on learning a router for a fixed pool of LLMs. In this paper, we consider the problem of dynamic routing, where new, previously unobserved LLMs are available at test time. We propose a new approach to this problem that relies on representing each LLM as a feature vector, derived based on predictions on a set of representative prompts. Based on this, we detail two effective strategies, relying on cluster-based routing and a learned cluster map respectively. We prove that these strategies are estimates of a theoretically optimal routing rule, and provide an excess risk bound to quantify their errors. Experiments on a range of public benchmarks show the effectiveness of the proposed strategies in routing amongst more than 30 unseen LLMs.

When One LLM Drools, Multi-LLM Collaboration Rules

This position paper argues that in many realistic (i.e., complex, contextualized, subjective) scenarios, one LLM is not enough to produce a reliable output. We challenge the status quo of relying solely on a single general-purpose LLM and argue for multi-LLM collaboration to better represent the extensive diversity of data, skills, and people. We first posit that a single LLM underrepresents real-world data distributions, heterogeneous skills, and pluralistic populations, and that such representation gaps cannot be trivially patched by further training a single LLM. We then organize existing multi-LLM collaboration methods into a hierarchy, based on the level of access and information exchange, ranging from API-level, text-level, logit-level, to weight-level collaboration. Based on these methods, we highlight how multi-LLM collaboration addresses challenges that a single LLM struggles with, such as reliability, democratization, and pluralism. Finally, we identify the limitations of existing multi-LLM methods and motivate future work. We envision multi-LLM collaboration as an essential path toward compositional intelligence and collaborative AI development.

Heterogeneous Swarms: Jointly Optimizing Model Roles and Weights for Multi-LLM Systems

We propose Heterogeneous Swarms, an algorithm to design multi-LLM systems by jointly optimizing model roles and weights. We represent multi-LLM systems as directed acyclic graphs (DAGs) of LLMs with topological message passing for collaborative generation. Given a pool of LLM experts and a utility function, Heterogeneous Swarms employs two iterative steps: role-step and weight-step. For role-step, we interpret model roles as learning a DAG that specifies the flow of inputs and outputs between LLMs. Starting from a swarm of random continuous adjacency matrices, we decode them into discrete DAGs, call the LLMs in topological order, evaluate on the utility function (e.g. accuracy on a task), and optimize the adjacency matrices with particle swarm optimization based on the utility score. For weight-step, we assess the contribution of individual LLMs in the multi-LLM systems and optimize model weights with swarm intelligence. We propose JFK-score to quantify the individual contribution of each LLM in the best-found DAG of the role-step, then optimize model weights with particle swarm optimization based on the JFK-score. Experiments demonstrate that Heterogeneous Swarms outperforms 15 role- and/or weight-based baselines by 18.5% on average across 12 tasks. Further analysis reveals that Heterogeneous Swarms discovers multi-LLM systems with heterogeneous model roles and substantial collaborative gains, and benefits from the diversity of language models.

A foundation model for human-AI collaboration in medical literature mining

Systematic literature review is essential for evidence-based medicine, requiring comprehensive analysis of clinical trial publications. However, the application of artificial intelligence (AI) models for medical literature mining has been limited by insufficient training and evaluation across broad therapeutic areas and diverse tasks. Here, we present LEADS, an AI foundation model for study search, screening, and data extraction from medical literature. The model is trained on 633,759 instruction data points in LEADSInstruct, curated from 21,335 systematic reviews, 453,625 clinical trial publications, and 27,015 clinical trial registries. We showed that LEADS demonstrates consistent improvements over four cutting-edge generic large language models (LLMs) on six tasks. Furthermore, LEADS enhances expert workflows by providing supportive references following expert requests, streamlining processes while maintaining high-quality results. A study with 16 clinicians and medical researchers from 14 different institutions revealed that experts collaborating with LEADS achieved a recall of 0.81 compared to 0.77 experts working alone in study selection, with a time savings of 22.6%. In data extraction tasks, experts using LEADS achieved an accuracy of 0.85 versus 0.80 without using LEADS, alongside a 26.9% time savings. These findings highlight the potential of specialized medical literature foundation models to outperform generic models, delivering significant quality and efficiency benefits when integrated into expert workflows for medical literature mining.

Reverse Thinking Makes LLMs Stronger Reasoners

Reverse thinking plays a crucial role in human reasoning. Humans can reason not only from a problem to a solution but also in reverse, i.e., start from the solution and reason towards the problem. This often enhances overall reasoning performance as it enables consistency checks between their forward and backward thinking. To enable Large Language Models (LLMs) to perform reverse thinking, we introduce Reverse-Enhanced Thinking (RevThink), a framework composed of data augmentation and learning objectives. In RevThink, we augment the dataset by collecting structured forward-backward reasoning from a teacher model, consisting of: (1) the original question, (2) forward reasoning, (3) backward question, and (4) backward reasoning. We then employ three objectives to train a smaller student model in a multi-task learning fashion: (a) generate forward reasoning from a question, (b) generate a backward question from a question, and (c) generate backward reasoning from the backward question. Experiments across 12 datasets covering commonsense, math, and logical reasoning show an average 13.53% improvement over the student model's zero-shot performance and a 6.84% improvement over the strongest knowledge distillation baselines. Moreover, our method demonstrates sample efficiency -- using only 10% of the correct forward reasoning from the training data, it outperforms a standard fine-tuning method trained on 10x more forward reasoning. RevThink also exhibits strong generalization to out-of-distribution held-out datasets.

SynRL: Aligning Synthetic Clinical Trial Data with Human-preferred Clinical Endpoints Using Reinforcement Learning

Each year, hundreds of clinical trials are conducted to evaluate new medical interventions, but sharing patient records from these trials with other institutions can be challenging due to privacy concerns and federal regulations. To help mitigate privacy concerns, researchers have proposed methods for generating synthetic patient data. However, existing approaches for generating synthetic clinical trial data disregard the usage requirements of these data, including maintaining specific properties of clinical outcomes, and only use post hoc assessments that are not coupled with the data generation process. In this paper, we propose SynRL which leverages reinforcement learning to improve the performance of patient data generators by customizing the generated data to meet the user-specified requirements for synthetic data outcomes and endpoints. Our method includes a data value critic function to evaluate the quality of the generated data and uses reinforcement learning to align the data generator with the users' needs based on the critic's feedback. We performed experiments on four clinical trial datasets and demonstrated the advantages of SynRL in improving the quality of the generated synthetic data while keeping the privacy risks low. We also show that SynRL can be utilized as a general framework that can customize data generation of multiple types of synthetic data generators. Our code is available at https://anonymous.4open.science/r/SynRL-DB0F/.

Can Large Language Models Replace Data Scientists in Clinical Research?

Data science plays a critical role in clinical research, but it requires professionals with expertise in coding and medical data analysis. Large language models (LLMs) have shown great potential in supporting medical tasks and performing well in general coding tests. However, these tests do not assess LLMs' ability to handle data science tasks in medicine, nor do they explore their practical utility in clinical research. To address this, we developed a dataset consisting of 293 real-world data science coding tasks, based on 39 published clinical studies, covering 128 tasks in Python and 165 tasks in R. This dataset simulates realistic clinical research scenarios using patient data. Our findings reveal that cutting-edge LLMs struggle to generate perfect solutions, frequently failing to follow input instructions, understand target data, and adhere to standard analysis practices. Consequently, LLMs are not yet ready to fully automate data science tasks. We benchmarked advanced adaptation methods and found two to be particularly effective: chain-of-thought prompting, which provides a step-by-step plan for data analysis, which led to a 60% improvement in code accuracy; and self-reflection, enabling LLMs to iteratively refine their code, yielding a 38% accuracy improvement. Building on these insights, we developed a platform that integrates LLMs into the data science workflow for medical professionals. In a user study with five medical doctors, we found that while LLMs cannot fully automate coding tasks, they significantly streamline the programming process. We found that 80% of their submitted code solutions were incorporated from LLM-generated code, with up to 96% reuse in some cases. Our analysis highlights the potential of LLMs, when integrated into expert workflows, to enhance data science efficiency in clinical research.

A Perspective for Adapting Generalist AI to Specialized Medical AI Applications and Their Challenges

The integration of Large Language Models (LLMs) into medical applications has sparked widespread interest across the healthcare industry, from drug discovery and development to clinical decision support, assisting telemedicine, medical devices, and healthcare insurance applications. This perspective paper aims to discuss the inner workings of building LLM-powered medical AI applications and introduces a comprehensive framework for their development. We review existing literature and outline the unique challenges of applying LLMs in specialized medical contexts. Additionally, we introduce a three-step framework to organize medical LLM research activities: 1) Modeling: breaking down complex medical workflows into manageable steps for developing medical-specific models; 2) Optimization: optimizing the model performance with crafted prompts and integrating external knowledge and tools, and 3) System engineering: decomposing complex tasks into subtasks and leveraging human expertise for building medical AI applications. Furthermore, we offer a detailed use case playbook that describes various LLM-powered medical AI applications, such as optimizing clinical trial design, enhancing clinical decision support, and advancing medical imaging analysis. Finally, we discuss various challenges and considerations for building medical AI applications with LLMs, such as handling hallucination issues, data ownership and compliance, privacy, intellectual property considerations, compute cost, sustainability issues, and responsible AI requirements.

Demystifying Large Language Models for Medicine: A Primer

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.

OmnixR: Evaluating Omni-modality Language Models on Reasoning across Modalities

We introduce OmnixR, an evaluation suite designed to benchmark SoTA Omni-modality Language Models, such as GPT-4o and Gemini. Evaluating OLMs, which integrate multiple modalities such as text, vision, and audio, presents unique challenges. Particularly, the user message might often consist of multiple modalities, such that OLMs have to establish holistic understanding and reasoning across modalities to accomplish the task. Existing benchmarks are limited to single modality or dual-modality tasks, overlooking comprehensive multi-modal assessments of model reasoning. To address this, OmnixR offers two evaluation variants: (1)synthetic subset: a synthetic dataset generated automatically by translating text into multiple modalities--audio, images, video, and hybrids (Omnify). (2)realistic subset: a real-world dataset, manually curated and annotated by experts, for evaluating cross-modal reasoning in natural settings. OmnixR presents a unique evaluation towards assessing OLMs over a diverse mix of modalities, such as a question that involves video, audio, and text, providing a rigorous cross-modal reasoning testbed unlike any existing benchmarks. Our experiments find that all state-of-the-art OLMs struggle with OmnixR questions that require integrating information from multiple modalities to answer. Further analysis highlights differences in reasoning behavior, underscoring the challenges of omni-modal AI alignment.