Foundation Models to Unlock Real-World Evidence from Nationwide Medical Claims

Evidence derived from large-scale real-world data (RWD) is increasingly informing regulatory evaluation and healthcare decision-making. Administrative claims provide population-scale, longitudinal records of healthcare utilization, expenditure, and detailed coding of diagnoses, procedures, and medications, yet their potential as a substrate for healthcare foundation models remains largely unexplored. Here we present ReClaim, a generative transformer trained from scratch on 43.8 billion medical events from more than 200 million enrollees in the MarketScan claims data spanning 2008-2022. ReClaim models longitudinal trajectories across diagnoses, procedures, medications, and expenditure, and was scaled to 140 million, 700 million, and 1.7 billion parameters. Across over 1,000 disease-onset prediction tasks, ReClaim achieved a mean AUC of 75.6%, substantially outperforming disease-specific LightGBM (66.3%) and the transformer-based Delphi model (69.4%), with the largest gains for rare diseases. These advantages held across retrospective and prospective evaluations and in external validation on two independent datasets. Performance improved monotonically with scale, and post-training added 13.8 percentage points over pre-training alone. Beyond disease prediction, ReClaim captured financial outcomes and improved real-world evidence (RWE) analyses: for healthcare expenditure forecasting it increased explained variance from 0.28 to 0.37 relative to LightGBM, and in a target trial emulation it reduced systematic bias by 72% on average relative to Delphi. Together, these results establish administrative claims as a scalable substrate for healthcare foundation models and show that learned representations generalize across time periods and data sources, supporting disease surveillance, expenditure forecasting, and RWE generation.

Decompose, Structure, and Repair: A Neuro-Symbolic Framework for Autoformalization via Operator Trees

Statement autoformalization acts as a critical bridge between human mathematics and formal mathematics by translating natural language problems into formal language. While prior works have focused on data synthesis and diverse training paradigms to optimize end-to-end Large Language Models (LLMs), they typically treat formal code as flat sequences, neglecting the hierarchical logic inherent in mathematical statements. In this work, we introduce Decompose, Structure, and Repair (DSR), a neuro-symbolic framework that restructures autoformalization into a modular pipeline. DSR decomposes statements into logical components and maps them to structured operator trees, leveraging this topological blueprint to precisely localize and repair errors via sub-tree refinement. Furthermore, we introduce PRIME, a benchmark of 156 undergraduate and graduate-level theorems selected from canonical textbooks and expertly annotated in Lean 4. Experimental results demonstrate that DSR establishes a new state-of-the-art, consistently outperforming baselines under equivalent computational budgets. The datasets, model, and code will be released to the public soon.

SRAW-Attack: Space-Reweighted Adversarial Warping Attack for SAR Target Recognition

Synthetic aperture radar (SAR) imagery exhibits intrinsic information sparsity due to its unique electromagnetic scattering mechanism. Despite the widespread adoption of deep neural network (DNN)-based SAR automatic target recognition (SAR-ATR) systems, they remain vulnerable to adversarial examples and tend to over-rely on background regions, leading to degraded adversarial robustness. Existing adversarial attacks for SAR-ATR often require visually perceptible distortions to achieve effective performance, thereby necessitating an attack method that balances effectiveness and stealthiness. In this paper, a novel attack method termed Space-Reweighted Adversarial Warping (SRAW) is proposed, which generates adversarial examples through optimized spatial deformation with reweighted budgets across foreground and background regions. Extensive experiments demonstrate that SRAW significantly degrades the performance of state-of-the-art SAR-ATR models and consistently outperforms existing methods in terms of imperceptibility and adversarial transferability. Code is made available at https://github.com/boremycin/SAR-ATR-TransAttack.

ASSESS: A Semantic and Structural Evaluation Framework for Statement Similarity

Statement autoformalization, the automated translation of statements from natural language into formal languages, has seen significant advancements, yet the development of automated evaluation metrics remains limited. Existing metrics for formal statement similarity often fail to balance semantic and structural information. String-based approaches capture syntactic structure but ignore semantic meaning, whereas proof-based methods validate semantic equivalence but disregard structural nuances and, critically, provide no graded similarity score in the event of proof failure. To address these issues, we introduce ASSESS (A Semantic and Structural Evaluation Framework for Statement Similarity), which comprehensively integrates semantic and structural information to provide a continuous similarity score. Our framework first transforms formal statements into Operator Trees to capture their syntactic structure and then computes a similarity score using our novel TransTED (Transformation Tree Edit Distance) Similarity metric, which enhances traditional Tree Edit Distance by incorporating semantic awareness through transformations. For rigorous validation, we present EPLA (Evaluating Provability and Likeness for Autoformalization), a new benchmark of 524 expert-annotated formal statement pairs derived from miniF2F and ProofNet, with labels for both semantic provability and structural likeness. Experiments on EPLA demonstrate that TransTED Similarity outperforms existing methods, achieving state-of-the-art accuracy and the highest Kappa coefficient. The benchmark, and implementation code will be made public soon.

Generalized Tree Edit Distance (GTED): A Faithful Evaluation Metric for Statement Autoformalization

Statement autoformalization, the automated translation of statement from natural language into formal languages, has become a subject of extensive research, yet the development of robust automated evaluation metrics remains limited. Existing evaluation methods often lack semantic understanding, face challenges with high computational costs, and are constrained by the current progress of automated theorem proving. To address these issues, we propose GTED (Generalized Tree Edit Distance), a novel evaluation framework that first standardizes formal statements and converts them into operator trees, then determines the semantic similarity using the eponymous GTED metric. On the miniF2F and ProofNet benchmarks, GTED outperforms all baseline metrics by achieving the highest accuracy and Kappa scores, thus providing the community with a more faithful metric for automated evaluation. The code and experimental results are available at https://github.com/XiaoyangLiu-sjtu/GTED.

ATLAS: Autoformalizing Theorems through Lifting, Augmentation, and Synthesis of Data

Autoformalization, the process of automatically translating natural language mathematics into machine-verifiable formal language, has demonstrated advancements with the progress of large language models (LLMs). However, a key obstacle to further advancements is the scarcity of paired datasets that align natural language with formal language. To address this challenge, we introduce ATLAS (Autoformalizing Theorems through Lifting, Augmentation, and Synthesis of Data), an iterative data generation framework designed to produce large-scale, high-quality parallel theorem statements. With the proposed ATLAS running for 10 iterations, we construct an undergraduate-level dataset comprising 300k theorem statements and develop the ATLAS translator, achieving accuracies of 80.59% (pass@8) and 92.99% (pass@128) on ProofNet, significantly outperforming the base model (23.99% and 47.17%) and InternLM2-Math-Plus-7B (50.94% and 80.32%). Furthermore, the ATLAS translator also achieves state-of-the-art performance on both the high-school-level miniF2F dataset and the graduate-level MathQual dataset introduced in this work. The datasets, model, and code will be released to the public soon.