Breaking the Chain: A Causal Analysis of LLM Faithfulness to Intermediate Structures

Schema-guided reasoning pipelines ask LLMs to produce explicit intermediate structures -- rubrics, checklists, verification queries -- before committing to a final decision. But do these structures causally determine the output, or merely accompany it? We introduce a causal evaluation protocol that makes this directly measurable: by selecting tasks where a deterministic function maps intermediate structures to decisions, every controlled edit implies a unique correct output. Across eight models and three benchmarks, models appear self-consistent with their own intermediate structures but fail to update predictions after intervention in up to 60% of cases -- revealing that apparent faithfulness is fragile once the intermediate structure changes. When derivation of the final decision from the structure is delegated to an external tool, this fragility largely disappears; however, prompts which ask to prioritize the intermediate structure over the original input do not materially close the gap. Overall, intermediate structures in schema-guided pipelines function as influential context rather than stable causal mediators.

The benefits of query-based KGQA systems for complex and temporal questions in LLM era

Large language models excel in question-answering (QA) yet still struggle with multi-hop reasoning and temporal questions. Query-based knowledge graph QA (KGQA) offers a modular alternative by generating executable queries instead of direct answers. We explore multi-stage query-based framework for WikiData QA, proposing multi-stage approach that enhances performance on challenging multi-hop and temporal benchmarks. Through generalization and rejection studies, we evaluate robustness across multi-hop and temporal QA datasets. Additionally, we introduce a novel entity linking and predicate matching method using CoT reasoning. Our results demonstrate the potential of query-based multi-stage KGQA framework for improving multi-hop and temporal QA with small language models. Code and data: https://github.com/ar2max/NLDB-KGQA-System

Prompt to Polyp: Medical Text-Conditioned Image Synthesis with Diffusion Models

The generation of realistic medical images from text descriptions has significant potential to address data scarcity challenges in healthcare AI while preserving patient privacy. This paper presents a comprehensive study of text-to-image synthesis in the medical domain, comparing two distinct approaches: (1) fine-tuning large pre-trained latent diffusion models and (2) training small, domain-specific models. We introduce a novel model named MSDM, an optimized architecture based on Stable Diffusion that integrates a clinical text encoder, variational autoencoder, and cross-attention mechanisms to better align medical text prompts with generated images. Our study compares two approaches: fine-tuning large pre-trained models (FLUX, Kandinsky) versus training compact domain-specific models (MSDM). Evaluation across colonoscopy (MedVQA-GI) and radiology (ROCOv2) datasets reveals that while large models achieve higher fidelity, our optimized MSDM delivers comparable quality with lower computational costs. Quantitative metrics and qualitative evaluations by medical experts reveal strengths and limitations of each approach.

Prompt to Polyp: Clinically-Aware Medical Image Synthesis with Diffusion Models

The generation of realistic medical images from text descriptions has significant potential to address data scarcity challenges in healthcare AI while preserving patient privacy. This paper presents a comprehensive study of text-to-image synthesis in the medical domain, comparing two distinct approaches: (1) fine-tuning large pre-trained latent diffusion models and (2) training small, domain-specific models. We introduce a novel model named MSDM, an optimized architecture based on Stable Diffusion that integrates a clinical text encoder, variational autoencoder, and cross-attention mechanisms to better align medical text prompts with generated images. Our study compares two approaches: fine-tuning large pre-trained models (FLUX, Kandinsky) versus training compact domain-specific models (MSDM). Evaluation across colonoscopy (MedVQA-GI) and radiology (ROCOv2) datasets reveals that while large models achieve higher fidelity, our optimized MSDM delivers comparable quality with lower computational costs. Quantitative metrics and qualitative evaluations by medical experts reveal strengths and limitations of each approach.