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Jan 5

ClinLinker: Medical Entity Linking of Clinical Concept Mentions in Spanish

Advances in natural language processing techniques, such as named entity recognition and normalization to widely used standardized terminologies like UMLS or SNOMED-CT, along with the digitalization of electronic health records, have significantly advanced clinical text analysis. This study presents ClinLinker, a novel approach employing a two-phase pipeline for medical entity linking that leverages the potential of in-domain adapted language models for biomedical text mining: initial candidate retrieval using a SapBERT-based bi-encoder and subsequent re-ranking with a cross-encoder, trained by following a contrastive-learning strategy to be tailored to medical concepts in Spanish. This methodology, focused initially on content in Spanish, substantially outperforming multilingual language models designed for the same purpose. This is true even for complex scenarios involving heterogeneous medical terminologies and being trained on a subset of the original data. Our results, evaluated using top-k accuracy at 25 and other top-k metrics, demonstrate our approach's performance on two distinct clinical entity linking Gold Standard corpora, DisTEMIST (diseases) and MedProcNER (clinical procedures), outperforming previous benchmarks by 40 points in DisTEMIST and 43 points in MedProcNER, both normalized to SNOMED-CT codes. These findings highlight our approach's ability to address language-specific nuances and set a new benchmark in entity linking, offering a potent tool for enhancing the utility of digital medical records. The resulting system is of practical value, both for large scale automatic generation of structured data derived from clinical records, as well as for exhaustive extraction and harmonization of predefined clinical variables of interest.

  • 5 authors
·
Apr 9, 2024

Evaluating AI systems under uncertain ground truth: a case study in dermatology

For safety, medical AI systems undergo thorough evaluations before deployment, validating their predictions against a ground truth which is assumed to be fixed and certain. However, this ground truth is often curated in the form of differential diagnoses. While a single differential diagnosis reflects the uncertainty in one expert assessment, multiple experts introduce another layer of uncertainty through disagreement. Both forms of uncertainty are ignored in standard evaluation which aggregates these differential diagnoses to a single label. In this paper, we show that ignoring uncertainty leads to overly optimistic estimates of model performance, therefore underestimating risk associated with particular diagnostic decisions. To this end, we propose a statistical aggregation approach, where we infer a distribution on probabilities of underlying medical condition candidates themselves, based on observed annotations. This formulation naturally accounts for the potential disagreements between different experts, as well as uncertainty stemming from individual differential diagnoses, capturing the entire ground truth uncertainty. Our approach boils down to generating multiple samples of medical condition probabilities, then evaluating and averaging performance metrics based on these sampled probabilities. In skin condition classification, we find that a large portion of the dataset exhibits significant ground truth uncertainty and standard evaluation severely over-estimates performance without providing uncertainty estimates. In contrast, our framework provides uncertainty estimates on common metrics of interest such as top-k accuracy and average overlap, showing that performance can change multiple percentage points. We conclude that, while assuming a crisp ground truth can be acceptable for many AI applications, a more nuanced evaluation protocol should be utilized in medical diagnosis.

  • 20 authors
·
Jul 5, 2023

CleanMAP: Distilling Multimodal LLMs for Confidence-Driven Crowdsourced HD Map Updates

The rapid growth of intelligent connected vehicles (ICVs) and integrated vehicle-road-cloud systems has increased the demand for accurate, real-time HD map updates. However, ensuring map reliability remains challenging due to inconsistencies in crowdsourced data, which suffer from motion blur, lighting variations, adverse weather, and lane marking degradation. This paper introduces CleanMAP, a Multimodal Large Language Model (MLLM)-based distillation framework designed to filter and refine crowdsourced data for high-confidence HD map updates. CleanMAP leverages an MLLM-driven lane visibility scoring model that systematically quantifies key visual parameters, assigning confidence scores (0-10) based on their impact on lane detection. A novel dynamic piecewise confidence-scoring function adapts scores based on lane visibility, ensuring strong alignment with human evaluations while effectively filtering unreliable data. To further optimize map accuracy, a confidence-driven local map fusion strategy ranks and selects the top-k highest-scoring local maps within an optimal confidence range (best score minus 10%), striking a balance between data quality and quantity. Experimental evaluations on a real-world autonomous vehicle dataset validate CleanMAP's effectiveness, demonstrating that fusing the top three local maps achieves the lowest mean map update error of 0.28m, outperforming the baseline (0.37m) and meeting stringent accuracy thresholds (<= 0.32m). Further validation with real-vehicle data confirms 84.88% alignment with human evaluators, reinforcing the model's robustness and reliability. This work establishes CleanMAP as a scalable and deployable solution for crowdsourced HD map updates, ensuring more precise and reliable autonomous navigation. The code will be available at https://Ankit-Zefan.github.io/CleanMap/

  • 8 authors
·
Apr 14, 2025

Test-Time Scaling in Diffusion LLMs via Hidden Semi-Autoregressive Experts

Diffusion-based large language models (dLLMs) are trained flexibly to model extreme dependence in the data distribution; however, how to best utilize this information at inference time remains an open problem. In this work, we uncover an interesting property of these models: dLLMs trained on textual data implicitly learn a mixture of semi-autoregressive experts, where different generation orders reveal different specialized behaviors. We show that committing to any single, fixed inference time schedule, a common practice, collapses performance by failing to leverage this latent ensemble. To address this, we introduce HEX (Hidden semiautoregressive EXperts for test-time scaling), a training-free inference method that ensembles across heterogeneous block schedules. By doing a majority vote over diverse block-sized generation paths, HEX robustly avoids failure modes associated with any single fixed schedule. On reasoning benchmarks such as GSM8K, it boosts accuracy by up to 3.56X (from 24.72% to 88.10%), outperforming top-K margin inference and specialized fine-tuned methods like GRPO, without additional training. HEX even yields significant gains on MATH benchmark from 16.40% to 40.00%, scientific reasoning on ARC-C from 54.18% to 87.80%, and TruthfulQA from 28.36% to 57.46%. Our results establish a new paradigm for test-time scaling in diffusion-based LLMs (dLLMs), revealing that the sequence in which masking is performed plays a critical role in determining performance during inference.

Toolshed: Scale Tool-Equipped Agents with Advanced RAG-Tool Fusion and Tool Knowledge Bases

Recent advancements in tool-equipped Agents (LLMs) have enabled complex tasks like secure database interactions and multi-agent code development. However, scaling tool capacity beyond agent reasoning or model limits remains a challenge. In this paper, we address these challenges by introducing Toolshed Knowledge Bases, a tool knowledge base (vector database) designed to store enhanced tool representations and optimize tool selection for large-scale tool-equipped Agents. Additionally, we propose Advanced RAG-Tool Fusion, a novel ensemble of tool-applied advanced retrieval-augmented generation (RAG) techniques across the pre-retrieval, intra-retrieval, and post-retrieval phases, without requiring model fine-tuning. During pre-retrieval, tool documents are enhanced with key information and stored in the Toolshed Knowledge Base. Intra-retrieval focuses on query planning and transformation to increase retrieval accuracy. Post-retrieval refines the retrieved tool documents and enables self-reflection. Furthermore, by varying both the total number of tools (tool-M) an Agent has access to and the tool selection threshold (top-k), we address trade-offs between retrieval accuracy, agent performance, and token cost. Our approach achieves 46%, 56%, and 47% absolute improvements on the ToolE single-tool, ToolE multi-tool and Seal-Tools benchmark datasets, respectively (Recall@5).

  • 5 authors
·
Oct 18, 2024

Encyclo-K: Evaluating LLMs with Dynamically Composed Knowledge Statements

Benchmarks play a crucial role in tracking the rapid advancement of large language models (LLMs) and identifying their capability boundaries. However, existing benchmarks predominantly curate questions at the question level, suffering from three fundamental limitations: vulnerability to data contamination, restriction to single-knowledge-point assessment, and reliance on costly domain expert annotation. We propose Encyclo-K, a statement-based benchmark that rethinks benchmark construction from the ground up. Our key insight is that knowledge statements, not questions, can serve as the unit of curation, and questions can then be constructed from them. We extract standalone knowledge statements from authoritative textbooks and dynamically compose them into evaluation questions through random sampling at test time. This design directly addresses all three limitations: the combinatorial space is too vast to memorize, and model rankings remain stable across dynamically generated question sets, enabling reliable periodic dataset refresh; each question aggregates 8-10 statements for comprehensive multi-knowledge assessment; annotators only verify formatting compliance without requiring domain expertise, substantially reducing annotation costs. Experiments on over 50 LLMs demonstrate that Encyclo-K poses substantial challenges with strong discriminative power. Even the top-performing OpenAI-GPT-5.1 achieves only 62.07% accuracy, and model performance displays a clear gradient distribution--reasoning models span from 16.04% to 62.07%, while chat models range from 9.71% to 50.40%. These results validate the challenges introduced by dynamic evaluation and multi-statement comprehensive understanding. These findings establish Encyclo-K as a scalable framework for dynamic evaluation of LLMs' comprehensive understanding over multiple fine-grained disciplinary knowledge statements.

  • 17 authors
·
Dec 31, 2025

Benchmarking the CoW with the TopCoW Challenge: Topology-Aware Anatomical Segmentation of the Circle of Willis for CTA and MRA

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neurovascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two non-invasive angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited datasets with annotations on CoW anatomy, especially for CTA. Therefore, we organized the TopCoW challenge with the release of an annotated CoW dataset. The TopCoW dataset is the first public dataset with voxel-level annotations for 13 CoW vessel components, enabled by virtual reality technology. It is also the first large dataset using 200 pairs of MRA and CTA from the same patients. As part of the benchmark, we invited submissions worldwide and attracted over 250 registered participants from six continents. The submissions were evaluated on both internal and external test datasets of 226 scans from over five centers. The top performing teams achieved over 90% Dice scores at segmenting the CoW components, over 80% F1 scores at detecting key CoW components, and over 70% balanced accuracy at classifying CoW variants for nearly all test sets. The best algorithms also showed clinical potential in classifying fetal-type posterior cerebral artery and locating aneurysms with CoW anatomy. TopCoW demonstrated the utility and versatility of CoW segmentation algorithms for a wide range of downstream clinical applications with explainability. The annotated datasets and best performing algorithms have been released as public Zenodo records to foster further methodological development and clinical tool building.

  • 113 authors
·
Dec 29, 2023