VERI-DPO: Evidence-Aware Alignment for Clinical Summarization via Claim Verification and Direct Preference Optimization

Brief Hospital Course (BHC) narratives must be clinically useful yet faithful to fragmented EHR evidence. LLM-based clinical summarizers still introduce unsupported statements, and alignment can encourage omissions ("say-less" degeneration). We introduce VERI-DPO, which uses claim verification to mine preferences and distill them into the summarizer with Direct Preference Optimization (DPO). On MIMIC-III-Ext-VeriFact-BHC (100 ICU patients; patient-level splits), we train a retrieval-augmented verifier to label claim-evidence pairs as Supported, Not Supported, or Not Addressed via a single-token format. The verifier scores sentence-level claims from sampled BHC candidates and aggregates margins into a coverage-aware utility to mine length-controlled, contradiction-anchored preference pairs. On held-out patients, verifier-mined preferences separate candidates by contradiction density, and VERI-DPO reduces Not Supported claim rates from 10.7% to 1.9% (local verifier judge) and from 11.6% to 6.4% (GPT-4o judge), while improving validity from 76.7% to 82.5% and maintaining informative length.

Learning When to Sample: Confidence-Aware Self-Consistency for Efficient LLM Chain-of-Thought Reasoning

Large language models (LLMs) achieve strong reasoning performance through chain-of-thought (CoT) reasoning, yet often generate unnecessarily long reasoning paths that incur high inference cost. Recent self-consistency-based approaches further improve accuracy but require sampling and aggregating multiple reasoning trajectories, leading to substantial additional computational overhead. This paper introduces a confidence-aware decision framework that analyzes a single completed reasoning trajectory to adaptively select between single-path and multi-path reasoning. The framework is trained using sentence-level numeric and linguistic features extracted from intermediate reasoning states in the MedQA dataset and generalizes effectively to MathQA, MedMCQA, and MMLU without additional fine-tuning. Experimental results show that the proposed method maintains accuracy comparable to multi-path baselines while using up to 80\% fewer tokens. These findings demonstrate that reasoning trajectories contain rich signals for uncertainty estimation, enabling a simple, transferable mechanism to balance accuracy and efficiency in LLM reasoning.

Catalysts of Conversation: Examining Interaction Dynamics Between Topic Initiators and Commentors in Alzheimer's Disease Online Communities

Informal caregivers (e.g.,family members or friends) of people living with Alzheimers Disease and Related Dementias (ADRD) face substantial challenges and often seek informational or emotional support through online communities. Understanding the factors that drive engagement within these platforms is crucial, as it can enhance their long-term value for caregivers by ensuring that these communities effectively meet their needs. This study investigated the user interaction dynamics within two large, popular ADRD communities, TalkingPoint and ALZConnected, focusing on topic initiator engagement, initial post content, and the linguistic patterns of comments at the thread level. Using analytical methods such as propensity score matching, topic modeling, and predictive modeling, we found that active topic initiator engagement drives higher comment volumes, and reciprocal replies from topic initiators encourage further commentor engagement at the community level. Practical caregiving topics prompt more re-engagement of topic initiators, while emotional support topics attract more comments from other commentors. Additionally, the linguistic complexity and emotional tone of a comment influence its likelihood of receiving replies from topic initiators. These findings highlight the importance of fostering active and reciprocal engagement and providing effective strategies to enhance sustainability in ADRD caregiving and broader health-related online communities.