Generating Multi-Table Time Series EHR from Latent Space with Minimal Preprocessing

Electronic Health Records (EHR) are time-series relational databases that record patient interactions and medical events over time, serving as a critical resource for healthcare research and applications. However, privacy concerns and regulatory restrictions limit the sharing and utilization of such sensitive data, necessitating the generation of synthetic EHR datasets. Unlike previous EHR synthesis methods, which typically generate medical records consisting of expert-chosen features (e.g. a few vital signs or structured codes only), we introduce RawMed, the first framework to synthesize multi-table, time-series EHR data that closely resembles raw EHRs. Using text-based representation and compression techniques, RawMed captures complex structures and temporal dynamics with minimal preprocessing. We also propose a new evaluation framework for multi-table time-series synthetic EHRs, assessing distributional similarity, inter-table relationships, temporal dynamics, and privacy. Validated on two open-source EHR datasets, RawMed outperforms baseline models in fidelity and utility. The code is available at https://github.com/eunbyeol-cho/RawMed.

MD-ViSCo: A Unified Model for Multi-Directional Vital Sign Waveform Conversion

Despite the remarkable progress of deep-learning methods generating a target vital sign waveform from a source vital sign waveform, most existing models are designed exclusively for a specific source-to-target pair. This requires distinct model architectures, optimization procedures, and pre-processing pipelines, resulting in multiple models that hinder usability in clinical settings. To address this limitation, we propose the Multi-Directional Vital-Sign Converter (MD-ViSCo), a unified framework capable of generating any target waveform such as electrocardiogram (ECG), photoplethysmogram (PPG), or arterial blood pressure (ABP) from any single input waveform with a single model. MD-ViSCo employs a shallow 1-Dimensional U-Net integrated with a Swin Transformer that leverages Adaptive Instance Normalization (AdaIN) to capture distinct waveform styles. To evaluate the efficacy of MD-ViSCo, we conduct multi-directional waveform generation on two publicly available datasets. Our framework surpasses state-of-the-art baselines (NabNet & PPG2ABP) on average across all waveform types, lowering Mean absolute error (MAE) by 8.8% and improving Pearson correlation (PC) by 4.9% over two datasets. In addition, the generated ABP waveforms satisfy the Association for the Advancement of Medical Instrumentation (AAMI) criterion and achieve Grade B on the British Hypertension Society (BHS) standard, outperforming all baselines. By eliminating the need for developing a distinct model for each task, we believe that this work offers a unified framework that can deal with any kind of vital sign waveforms with a single model in healthcare monitoring.

Lunguage: A Benchmark for Structured and Sequential Chest X-ray Interpretation

Radiology reports convey detailed clinical observations and capture diagnostic reasoning that evolves over time. However, existing evaluation methods are limited to single-report settings and rely on coarse metrics that fail to capture fine-grained clinical semantics and temporal dependencies. We introduce LUNGUAGE,a benchmark dataset for structured radiology report generation that supports both single-report evaluation and longitudinal patient-level assessment across multiple studies. It contains 1,473 annotated chest X-ray reports, each reviewed by experts, and 80 of them contain longitudinal annotations to capture disease progression and inter-study intervals, also reviewed by experts. Using this benchmark, we develop a two-stage framework that transforms generated reports into fine-grained, schema-aligned structured representations, enabling longitudinal interpretation. We also propose LUNGUAGESCORE, an interpretable metric that compares structured outputs at the entity, relation, and attribute level while modeling temporal consistency across patient timelines. These contributions establish the first benchmark dataset, structuring framework, and evaluation metric for sequential radiology reporting, with empirical results demonstrating that LUNGUAGESCORE effectively supports structured report evaluation. The code is available at: https://github.com/SuperSupermoon/Lunguage

Trans-EnV: A Framework for Evaluating the Linguistic Robustness of LLMs Against English Varieties

Large Language Models (LLMs) are predominantly evaluated on Standard American English (SAE), often overlooking the diversity of global English varieties. This narrow focus may raise fairness concerns as degraded performance on non-standard varieties can lead to unequal benefits for users worldwide. Therefore, it is critical to extensively evaluate the linguistic robustness of LLMs on multiple non-standard English varieties. We introduce Trans-EnV, a framework that automatically transforms SAE datasets into multiple English varieties to evaluate the linguistic robustness. Our framework combines (1) linguistics expert knowledge to curate variety-specific features and transformation guidelines from linguistic literature and corpora, and (2) LLM-based transformations to ensure both linguistic validity and scalability. Using Trans-EnV, we transform six benchmark datasets into 38 English varieties and evaluate seven state-of-the-art LLMs. Our results reveal significant performance disparities, with accuracy decreasing by up to 46.3% on non-standard varieties. These findings highlight the importance of comprehensive linguistic robustness evaluation across diverse English varieties. Each construction of Trans-EnV was validated through rigorous statistical testing and consultation with a researcher in the field of second language acquisition, ensuring its linguistic validity. Our \href{https://github.com/jiyounglee-0523/TransEnV}{code} and \href{https://huggingface.co/collections/jiyounglee0523/transenv-681eadb3c0c8cf363b363fb1}{datasets} are publicly available.

CXReasonBench: A Benchmark for Evaluating Structured Diagnostic Reasoning in Chest X-rays

Recent progress in Large Vision-Language Models (LVLMs) has enabled promising applications in medical tasks, such as report generation and visual question answering. However, existing benchmarks focus mainly on the final diagnostic answer, offering limited insight into whether models engage in clinically meaningful reasoning. To address this, we present CheXStruct and CXReasonBench, a structured pipeline and benchmark built on the publicly available MIMIC-CXR-JPG dataset. CheXStruct automatically derives a sequence of intermediate reasoning steps directly from chest X-rays, such as segmenting anatomical regions, deriving anatomical landmarks and diagnostic measurements, computing diagnostic indices, and applying clinical thresholds. CXReasonBench leverages this pipeline to evaluate whether models can perform clinically valid reasoning steps and to what extent they can learn from structured guidance, enabling fine-grained and transparent assessment of diagnostic reasoning. The benchmark comprises 18,988 QA pairs across 12 diagnostic tasks and 1,200 cases, each paired with up to 4 visual inputs, and supports multi-path, multi-stage evaluation including visual grounding via anatomical region selection and diagnostic measurements. Even the strongest of 10 evaluated LVLMs struggle with structured reasoning and generalization, often failing to link abstract knowledge with anatomically grounded visual interpretation. The code is available at https://github.com/ttumyche/CXReasonBench

PatientSim: A Persona-Driven Simulator for Realistic Doctor-Patient Interactions

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluated eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3, was validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare.

Enhancing LLMs' Clinical Reasoning with Real-World Data from a Nationwide Sepsis Registry

Although large language models (LLMs) have demonstrated impressive reasoning capabilities across general domains, their effectiveness in real-world clinical practice remains limited. This is likely due to their insufficient exposure to real-world clinical data during training, as such data is typically not included due to privacy concerns. To address this, we propose enhancing the clinical reasoning capabilities of LLMs by leveraging real-world clinical data. We constructed reasoning-intensive questions from a nationwide sepsis registry and fine-tuned Phi-4 on these questions using reinforcement learning, resulting in C-Reason. C-Reason exhibited strong clinical reasoning capabilities on the in-domain test set, as evidenced by both quantitative metrics and expert evaluations. Furthermore, its enhanced reasoning capabilities generalized to a sepsis dataset involving different tasks and patient cohorts, an open-ended consultations on antibiotics use task, and other diseases. Future research should focus on training LLMs with large-scale, multi-disease clinical datasets to develop more powerful, general-purpose clinical reasoning models.

LabTOP: A Unified Model for Lab Test Outcome Prediction on Electronic Health Records

Lab tests are fundamental for diagnosing diseases and monitoring patient conditions. However, frequent testing can be burdensome for patients, and test results may not always be immediately available. To address these challenges, we propose LabTOP, a unified model that predicts lab test outcomes by leveraging a language modeling approach on EHR data. Unlike conventional methods that estimate only a subset of lab tests or classify discrete value ranges, LabTOP performs continuous numerical predictions for a diverse range of lab items. We evaluate LabTOP on three publicly available EHR datasets and demonstrate that it outperforms existing methods, including traditional machine learning models and state-of-the-art large language models. We also conduct extensive ablation studies to confirm the effectiveness of our design choices. We believe that LabTOP will serve as an accurate and generalizable framework for lab test outcome prediction, with potential applications in clinical decision support and early detection of critical conditions.

R2-KG: General-Purpose Dual-Agent Framework for Reliable Reasoning on Knowledge Graphs

Recent studies have combined Large Language Models (LLMs) with Knowledge Graphs (KGs) to enhance reasoning, improving inference accuracy without additional training while mitigating hallucination. However, existing frameworks are often rigid, struggling to adapt to KG or task changes. They also rely heavily on powerful LLMs for reliable (i.e., trustworthy) reasoning. To address this, We introduce R2-KG, a plug-and-play, dual-agent framework that separates reasoning into two roles: an Operator (a low-capacity LLM) that gathers evidence and a Supervisor (a high-capacity LLM) that makes final judgments. This design is cost-efficient for LLM inference while still maintaining strong reasoning accuracy. Additionally, R2-KG employs an Abstention mechanism, generating answers only when sufficient evidence is collected from KG, which significantly enhances reliability. Experiments across multiple KG-based reasoning tasks show that R2-KG consistently outperforms baselines in both accuracy and reliability, regardless of the inherent capability of LLMs used as the Operator. Further experiments reveal that the single-agent version of R2-KG, equipped with a strict self-consistency strategy, achieves significantly higher-than-baseline reliability while reducing inference cost. However, it also leads to a higher abstention rate in complex KGs. Our findings establish R2-KG as a flexible and cost-effective solution for KG-based reasoning. It reduces reliance on high-capacity LLMs while ensuring trustworthy inference.

Ensembling Large Language Models with Process Reward-Guided Tree Search for Better Complex Reasoning

Despite recent advances in large language models, open-source models often struggle to consistently perform well on complex reasoning tasks. Existing ensemble methods, whether applied at the token or output levels, fail to address these challenges. In response, we present Language model Ensemble with Monte Carlo Tree Search (LE-MCTS), a novel framework for process-level ensembling of language models. LE-MCTS formulates step-by-step reasoning with an ensemble of language models as a Markov decision process. In this framework, states represent intermediate reasoning paths, while actions consist of generating the next reasoning step using one of the language models selected from a predefined pool. Guided by a process-based reward model, LE-MCTS performs a tree search over the reasoning steps generated by different language models, identifying the most accurate reasoning chain. Experimental results on five mathematical reasoning benchmarks demonstrate that our approach outperforms both single language model decoding algorithms and language model ensemble methods. Notably, LE-MCTS improves performance by 3.6% and 4.3% on the MATH and MQA datasets, respectively, highlighting its effectiveness in solving complex reasoning problems.