"What's Up, Doc?": Analyzing How Users Seek Health Information in Large-Scale Conversational AI Datasets

People are increasingly seeking healthcare information from large language models (LLMs) via interactive chatbots, yet the nature and inherent risks of these conversations remain largely unexplored. In this paper, we filter large-scale conversational AI datasets to achieve HealthChat-11K, a curated dataset of 11K real-world conversations composed of 25K user messages. We use HealthChat-11K and a clinician-driven taxonomy for how users interact with LLMs when seeking healthcare information in order to systematically study user interactions across 21 distinct health specialties. Our analysis reveals insights into the nature of how and why users seek health information, such as common interactions, instances of incomplete context, affective behaviors, and interactions (e.g., leading questions) that can induce sycophancy, underscoring the need for improvements in the healthcare support capabilities of LLMs deployed as conversational AI. Code and artifacts to retrieve our analyses and combine them into a curated dataset can be found here: https://github.com/yahskapar/HealthChat

ABBA: Highly Expressive Hadamard Product Adaptation for Large Language Models

Large Language Models have demonstrated strong performance across a wide range of tasks, but adapting them efficiently to new domains remains a key challenge. Parameter-Efficient Fine-Tuning (PEFT) methods address this by introducing lightweight, trainable modules while keeping most pre-trained weights fixed. The prevailing approach, LoRA, models updates using a low-rank decomposition, but its expressivity is inherently constrained by the rank. Recent methods like HiRA aim to increase expressivity by incorporating a Hadamard product with the frozen weights, but still rely on the structure of the pre-trained model. We introduce ABBA, a new PEFT architecture that reparameterizes the update as a Hadamard product of two independently learnable low-rank matrices. In contrast to prior work, ABBA fully decouples the update from the pre-trained weights, enabling both components to be optimized freely. This leads to significantly higher expressivity under the same parameter budget. We formally analyze ABBA's expressive capacity and validate its advantages through matrix reconstruction experiments. Empirically, ABBA achieves state-of-the-art results on arithmetic and commonsense reasoning benchmarks, consistently outperforming existing PEFT methods by a significant margin across multiple models. Our code is publicly available at: https://github.com/CERT-Lab/abba.

Fed-SB: A Silver Bullet for Extreme Communication Efficiency and Performance in (Private) Federated LoRA Fine-Tuning

Low-Rank Adaptation (LoRA) has become ubiquitous for efficiently fine-tuning foundation models. However, federated fine-tuning using LoRA is challenging due to suboptimal updates arising from traditional federated averaging of individual adapters. Existing solutions either incur prohibitively high communication cost that scales linearly with the number of clients or suffer from performance degradation due to limited expressivity. We introduce Federated Silver Bullet (Fed-SB), a novel approach for federated fine-tuning of LLMs using LoRA-SB, a recently proposed low-rank adaptation method. LoRA-SB optimally aligns the optimization trajectory with the ideal low-rank full fine-tuning projection by learning a small square matrix (R) between adapters B and A, keeping other components fixed. Direct averaging of R guarantees exact updates, substantially reducing communication cost, which remains independent of the number of clients, and enables scalability. Fed-SB achieves state-of-the-art performance across commonsense reasoning, arithmetic reasoning, and language inference tasks while reducing communication costs by up to 230x. In private settings, Fed-SB further improves performance by (1) reducing trainable parameters, thereby lowering the noise required for differential privacy and (2) avoiding noise amplification introduced by other methods. Overall, Fed-SB establishes a new Pareto frontier in the tradeoff between communication and performance, offering an efficient and scalable solution for both private and non-private federated fine-tuning. Our code is publicly available at https://github.com/CERT-Lab/fed-sb.