Abstract:Reconstructing continuous speech from scalp electroencephalography (EEG) remains fundamentally challenging. EEG provides a weak, spatially diffuse, and highly variable measurement of distributed cortical activity, whereas speech is organized as a coherent acoustic trajectory with strong harmonic and temporal structure. The resulting mismatch makes waveform regression unstable and causes stochastic multi-step generation to be sensitive to artifact-dependent conditioning and subject variability. We introduce NeuroSonic, a conditional flow-matching framework for EEG-to-speech reconstruction. Instead of predicting waveforms directly or refining them through stochastic denoising, NeuroSonic learns a deterministic probability-flow velocity field that transports a noise-corrupted acoustic state toward clean speech under EEG conditioning. EEG and audio are embedded into a shared token space and processed by a time-conditioned gated Transformer that parameterizes the transport ordinary differential equation. This formulation models trajectory evolution explicitly while avoiding iterative stochastic sampling. We evaluate NeuroSonic on the CineBrain and EAV benchmarks under cross-subject evaluation. Across both datasets, the proposed method improves distributional realism, spectral fidelity, and perceptual quality over representative GAN-, diffusion-, and mean-flow baselines, with up to a 26.3\% gain in overall perceptual quality. The performance gap is most evident in artifact-heavy segments, where conditioning variability is strongest. These findings indicate that deterministic conditional transport provides a stable and effective formulation for EEG-driven speech reconstruction. Code is available at https://github.com/Y-Research-SBU/NeuroSonic/ .
Abstract:Patient safety event triage, determining whether a clinical event is reportable under jurisdiction-specific policy, is a high-stakes task typically performed manually by patient safety experts. Although LLMs may support this workflow, reliable evaluation is limited by the lack of benchmarks to capture evidence-grounded policy reasoning, proactive information seeking for incomplete reports, and principled abstention in irreducibly ambiguous cases. We address this gap with a policy-grounded construction methodology centered on the clause card, a structured representation that factorizes regulatory text into auditable decision specifications. Combining clause cards with anchor-driven instantiation and closed-loop verification, our scalable pipeline produces narratives with by-construction ground truth and naturally supports generating missing information and uncertain variants. We instantiate this method on Minnesota's 29 Reportable Adverse Health Events, producing PSEBench, a 5,074-case benchmark with an agentic evaluation environment. Evaluation on 15 representative LLMs reveals consistent capability trends, demonstrates the benchmark's utility, and identifies actionable gaps toward reliable LLM-based patient safety event triage.
Abstract:Clinical decision-making (CDM) is central to real-world clinical workflows, where clinicians infer diagnoses, select treatments, or anticipate future health outcomes under incomplete evidence. LLMs are increasingly used to support these decisions due to strong language capabilities, broad biomedical knowledge, and efficiency, yet the reliability of LLMs on real-world clinical decision tasks remains insufficiently understood. To evaluate CDM models, especially LLM-based models, an ideal and practical medical decision benchmark should be constructed via an automated yet reliable pipeline to ensure both scale and quality. Moreover, the grounding of a CDM benchmark in real patient EHRs can better support evaluation on practical CDM tasks that require substantive biomedical knowledge and clinical inference. To fill the gaps, we introduce EHRBench, an automated and reliable EHR-grounded benchmark for evaluating LLM-based clinical decision-making at scale. To ensure scalability and reliability, EHRBench is constructed through an EHR-LLM-KB(knowledge-base) interaction pipeline. For efficiency, we use a specialized LLM to automatically convert encounter-level EHR trajectories into structured templates and deterministically instantiate the templates into QA items. In parallel, we apply systematic KB-based verification and enrichment to filter hallucinated or ambiguous relations and to improve reliability. Using this pipeline, we construct nearly 1M (960,067) QA items spanning three core inference-required clinical decision tasks: diagnosis, treatment, and prognosis. We benchmark more than 30 representative LLMs on EHRBench and provide detailed analyses of performance and robustness. The results show consistent capability trends across settings, further validating the reliability of EHRBench and highlighting actionable gaps toward clinically reliable LLM systems.
Abstract:Transforming neuroimaging data into clinically actionable biomarkers is a knowledge-intensive and labor-intensive process. Standardized workflows such as fMRIPrep have improved robustness and efficiency, but they are statically configured and cannot reason about downstream objectives, deliberate over alternative strategies, or close the loop between intermediate evidence and subsequent decisions in the way a human researcher would. This lack of closed-loop adaptation often leaves domain experts trapped in a cycle of manual trial-and-error to tune parameters and remediate pipeline failures, severely constraining the scalability of clinical biomarker development. To bridge this gap, we introduce NIAgent, a multi-agent system for autonomous end-to-end neuroimaging analysis. Unlike conventional flat tool-calling agents, NIAgent adopts a code-centric execution paradigm where specialist agents collaboratively synthesize and optimize executable programs over composable domain-specific primitives. This design enables robust, long-horizon workflow construction that adapts dynamically to runtime observations. Furthermore, we propose a hierarchical verification framework for autonomous quality control, integrating cohort-level metric screening with agentic visual inspection to drive evidence-grounded workflow remediation. Experiments on ADHD-200 and ADNI demonstrate that NIAgent outperforms standard workflow-based baselines in predictive performance while exhibiting sophisticated agentic behaviors, including strategy exploration and adaptive refinement.
Abstract:Large reasoning models, such as OpenAI o1 and DeepSeek-R1, tend to become increasingly verbose as their reasoning capabilities improve. These inflated Chain-of-Thought (CoT) trajectories often exceed what the underlying problems require, wasting compute, latency, and context budgets. While introducing length-based efficiency rewards during reinforcement learning offers a natural remedy, existing methods struggle with two fundamental challenges: the optimal balance between correctness and efficiency is non-stationary throughout training, and intrinsic reasoning budgets vary drastically across problems. Relying on static reward weights and global length constraints inevitably forces a compromise between degraded accuracy and unrealized compression. To overcome these limitations, we propose LEAD (Length-Efficient Adaptive and Dynamic reasoning), a method that replaces static heuristics with online, self-adaptive mechanisms. LEAD dynamically calibrates the correctness-efficiency trade-off at each step using a Potential-Scaled Instability, directing optimization capacity to the most informative learning signal. Furthermore, it estimates an adaptive per-problem target length online based on the model's own correct rollouts, applying a symmetric efficiency reward that penalizes both overthinking and over-compression. Evaluated on five mathematical reasoning benchmarks, LEAD achieves the highest accuracy and Accuracy-Efficiency Score among RL-trained efficient-reasoning methods while producing substantially shorter outputs than the base model.
Abstract:Recent advances in large language models (LLMs) have enabled promising progress in diagnosis prediction from electronic health records (EHRs). However, existing LLM-based approaches tend to overfit to historically observed diagnoses, often overlooking novel yet clinically important conditions that are critical for early intervention. To address this, we propose EviCare, an in-context reasoning framework that integrates deep model guidance into LLM-based diagnosis prediction. Rather than prompting LLMs directly with raw EHR inputs, EviCare performs (1) deep model inference for candidate selection, (2) evidential prioritization for set-based EHRs, and (3) relational evidence construction for novel diagnosis prediction. These signals are then composed into an adaptive in-context prompt to guide LLM reasoning in an accurate and interpretable manner. Extensive experiments on two real-world EHR benchmarks (MIMIC-III and MIMIC-IV) demonstrate that EviCare achieves significant performance gains, which consistently outperforms both LLM-only and deep model-only baselines by an average of 20.65\% across precision and accuracy metrics. The improvements are particularly notable in challenging novel diagnosis prediction, yielding average improvements of 30.97\%.
Abstract:Lead optimization in drug discovery requires improving therapeutic properties while ensuring that proposed molecular modifications correspond to feasible synthetic routes. Existing approaches either prioritize property scores without enforcing synthesizability, or rely on expensive enumeration over large reaction networks, while direct application of Large Language Models (LLMs) frequently produces chemically invalid structures. We introduce MolReAct, a framework that formulates lead optimization as a Markov Decision Process over a synthesis-constrained action space defined by validated reaction templates. A tool-augmented LLM agent serves as a dynamic reaction environment that invokes specialized chemical analysis tools to identify reactive sites and propose chemically grounded transformations from matched templates. A policy model trained via Group Relative Policy Optimization (GRPO) selects among these constrained actions to maximize long-term oracle reward across multi-step reaction trajectories. A SMILES-based caching mechanism further reduces end-to-end optimization time by approximately 43%. Across 13 property optimization tasks from the Therapeutic Data Commons and one structure-based docking task, MolReAct achieves an average Top-10 score of 0.563, outperforming the strongest synthesizable baseline by 10.4% in relative improvement, and attains the best sample efficiency on 10 of 14 tasks. Ablations confirm that both tool-augmented reaction proposals and trajectory-level policy optimization contribute complementary gains. By grounding every step in validated reaction templates, MolReAct produces molecules that are property-improved and each accompanied by an explicit synthetic pathway.
Abstract:Evidence-based medicine (EBM) is central to high-quality care, but remains difficult to implement in fast-paced primary care settings. Physicians face short consultations, increasing patient loads, and lengthy guideline documents that are impractical to consult in real time. To address this gap, we investigate the feasibility of using large language models (LLMs) as ambient assistants that surface targeted, evidence-based questions during physician-patient encounters. Our study focuses on question generation rather than question answering, with the aim of scaffolding physician reasoning and integrating guideline-based practice into brief consultations. We implemented two prompting strategies, a zero-shot baseline and a multi-stage reasoning variant, using Gemini 2.5 as the backbone model. We evaluated on a benchmark of 80 de-identified transcripts from real clinical encounters, with six experienced physicians contributing over 90 hours of structured review. Results indicate that while general-purpose LLMs are not yet fully reliable, they can produce clinically meaningful and guideline-relevant questions, suggesting significant potential to reduce cognitive burden and make EBM more actionable at the point of care.
Abstract:Accurate extraction of Alzheimer's Disease and Related Dementias (ADRD) phenotypes from electronic health records (EHR) is critical for early-stage detection and disease staging. However, this information is usually embedded in unstructured textual data rather than tabular data, making it difficult to be extracted accurately. We therefore propose LLM-MINE, a Large Language Model-based phenotype mining framework for automatic extraction of ADRD phenotypes from clinical notes. Using two expert-defined phenotype lists, we evaluate the extracted phenotypes by examining their statistical significance across cohorts and their utility for unsupervised disease staging. Chi-square analyses confirm statistically significant phenotype differences across cohorts, with memory impairment being the strongest discriminator. Few-shot prompting with the combined phenotype lists achieves the best clustering performance (ARI=0.290, NMI=0.232), substantially outperforming biomedical NER and dictionary-based baselines. Our results demonstrate that LLM-based phenotype extraction is a promising tool for discovering clinically meaningful ADRD signals from unstructured notes.
Abstract:Electrocardiography (ECG) analysis is crucial for cardiac diagnosis, yet existing foundation models often fail to capture the periodicity and diverse features required for varied clinical tasks. We propose ECG-MoE, a hybrid architecture that integrates multi-model temporal features with a cardiac period-aware expert module. Our approach uses a dual-path Mixture-of-Experts to separately model beat-level morphology and rhythm, combined with a hierarchical fusion network using LoRA for efficient inference. Evaluated on five public clinical tasks, ECG-MoE achieves state-of-the-art performance with 40% faster inference than multi-task baselines.