new

Get trending papers in your email inbox!

Subscribe

Daily Papers

byAK and the research community

Sep 25

Integrating Clinical Knowledge Graphs and Gradient-Based Neural Systems for Enhanced Melanoma Diagnosis via the 7-Point Checklist

The 7-point checklist (7PCL) is a widely used diagnostic tool in dermoscopy for identifying malignant melanoma by assigning point values to seven specific attributes. However, the traditional 7PCL is limited to distinguishing between malignant melanoma and melanocytic Nevi, and falls short in scenarios where multiple skin diseases with appearances similar to melanoma coexist. To address this limitation, we propose a novel diagnostic framework that integrates a clinical knowledge-based topological graph (CKTG) with a gradient diagnostic strategy featuring a data-driven weighting system (GD-DDW). The CKTG captures both the internal and external relationships among the 7PCL attributes, while the GD-DDW emulates dermatologists' diagnostic processes, prioritizing visual observation before making predictions. Additionally, we introduce a multimodal feature extraction approach leveraging a dual-attention mechanism to enhance feature extraction through cross-modal interaction and unimodal collaboration. This method incorporates meta-information to uncover interactions between clinical data and image features, ensuring more accurate and robust predictions. Our approach, evaluated on the EDRA dataset, achieved an average AUC of 88.6%, demonstrating superior performance in melanoma detection and feature prediction. This integrated system provides data-driven benchmarks for clinicians, significantly enhancing the precision of melanoma diagnosis.

  • 7 authors
·
Jul 23, 2024

Evolving Diagnostic Agents in a Virtual Clinical Environment

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

The Double Dilemma in Multi-Task Radiology Report Generation: A Gradient Dynamics Analysis and Solution

While multi-task learning based automatic radiology report generation (RRG) is widely adopted to ensure clinical consistency, most focus on architectural designs yet remain limited to coarse linear scalarization strategies. These strategies cannot effectively balance the hard constraints of discriminative clinical supervision with the smoothness requirements of report generation. To address these problems, we analyze the failure mechanism of linear scalarization from the perspective of gradient dynamics, utilizing the stochastic differential equation (SDE) framework to characterize it as a "Double Dilemma" of drift term deviation and diffusion term decay. Based on this, we propose a backbone-agnostic optimizer named Conflict-Averse Magnitude-Enhanced Gradient Descent (CAME-Grad). Through conflict-averse direction rectification and magnitude-enhanced energy injection, the algorithm not only ensures geometric validity, but also avoids local optimal solutions. Then, the adaptive gradient fusion mechanism is used to establish a dynamic balance between the theoretical optimal direction and the task-specific inductive bias. Experiments show that as a universal plug-and-play optimizer, CAME-Grad brings substantial and consistent improvements across eight diverse RRG methods, elevating overall clinical efficacy performance by an average of 2.3% on MIMIC-CXR and 1.9% on IU X-Ray. Our code is available at https://github.com/vpsg-research/CAME-Grad.

  • 4 authors
·
May 21

Refining Focus in AI for Lung Cancer: Comparing Lesion-Centric and Chest-Region Models with Performance Insights from Internal and External Validation

Background: AI-based classification models are essential for improving lung cancer diagnosis. However, the relative performance of lesion-level versus chest-region models in internal and external datasets remains unclear. Purpose: This study evaluates the performance of lesion-level and chest-region models for lung cancer classification, comparing their effectiveness across internal Duke Lung Nodule Dataset 2024 (DLND24) and external (LUNA16, NLST) datasets, with a focus on subgroup analyses by demographics, histology, and imaging characteristics. Materials and Methods: Two AI models were trained: one using lesion-centric patches (64,64,64) and the other using chest-region patches (512,512,8). Internal validation was conducted on DLND24, while external validation utilized LUNA16 and NLST datasets. The models performances were assessed using AUC-ROC, with subgroup analyses for demographic, clinical, and imaging factors. Statistical comparisons were performed using DeLongs test. Gradient-based visualizations and probability distribution were further used for analysis. Results: The lesion-level model consistently outperformed the chest-region model across datasets. In internal validation, the lesion-level model achieved an AUC of 0.71(CI: 0.61-0.81), compared to 0.68(0.57-0.77) for the chest-region model. External validation showed similar trends, with AUCs of 0.90(0.87-0.92) and 0.81(0.79-0.82) on LUNA16 and NLST, respectively. Subgroup analyses revealed significant advantages for lesion-level models in certain histological subtypes (adenocarcinoma) and imaging conditions (CT manufacturers). Conclusion: Lesion-level models demonstrate superior classification performance, especially for external datasets and challenging subgroups, suggesting their clinical utility for precision lung cancer diagnostics.

  • 1 authors
·
Nov 25, 2024

Revisiting Neuron Coverage Metrics and Quality of Deep Neural Networks

Deep neural networks (DNN) have been widely applied in modern life, including critical domains like autonomous driving, making it essential to ensure the reliability and robustness of DNN-powered systems. As an analogy to code coverage metrics for testing conventional software, researchers have proposed neuron coverage metrics and coverage-driven methods to generate DNN test cases. However, Yan et al. doubt the usefulness of existing coverage criteria in DNN testing. They show that a coverage-driven method is less effective than a gradient-based method in terms of both uncovering defects and improving model robustness. In this paper, we conduct a replication study of the work by Yan et al. and extend the experiments for deeper analysis. A larger model and a dataset of higher resolution images are included to examine the generalizability of the results. We also extend the experiments with more test case generation techniques and adjust the process of improving model robustness to be closer to the practical life cycle of DNN development. Our experiment results confirm the conclusion from Yan et al. that coverage-driven methods are less effective than gradient-based methods. Yan et al. find that using gradient-based methods to retrain cannot repair defects uncovered by coverage-driven methods. They attribute this to the fact that the two types of methods use different perturbation strategies: gradient-based methods perform differentiable transformations while coverage-driven methods can perform additional non-differentiable transformations. We test several hypotheses and further show that even coverage-driven methods are constrained only to perform differentiable transformations, the uncovered defects still cannot be repaired by adversarial training with gradient-based methods. Thus, defensive strategies for coverage-driven methods should be further studied.

  • 4 authors
·
Dec 31, 2021

GCond: Gradient Conflict Resolution via Accumulation-based Stabilization for Large-Scale Multi-Task Learning

In multi-task learning (MTL), gradient conflict poses a significant challenge. Effective methods for addressing this problem, including PCGrad, CAGrad, and GradNorm, in their original implementations are computationally demanding, which significantly limits their application in modern large models and transformers. We propose Gradient Conductor (GCond), a method that builds upon PCGrad principles by combining them with gradient accumulation and an adaptive arbitration mechanism. We evaluated GCond on self-supervised learning tasks using MobileNetV3-Small and ConvNeXt architectures on the ImageNet 1K dataset and a combined head and neck CT scan dataset, comparing the proposed method against baseline linear combinations and state-of-the-art gradient conflict resolution methods. The stochastic mode of GCond achieved a two-fold computational speedup while maintaining optimization quality, and demonstrated superior performance across all evaluated metrics, achieving lower L1 and SSIM losses compared to other methods on both datasets. GCond exhibited high scalability, being successfully applied to both compact models (MobileNetV3-Small) and large architectures (ConvNeXt-tiny and ConvNeXt-Base). It also showed compatibility with modern optimizers such as AdamW and Lion/LARS. Therefore, GCond offers a scalable and efficient solution to the problem of gradient conflicts in multi-task learning.

  • 2 authors
·
Sep 8, 2025

Gradient-Normalized Smoothness for Optimization with Approximate Hessians

In this work, we develop new optimization algorithms that use approximate second-order information combined with the gradient regularization technique to achieve fast global convergence rates for both convex and non-convex objectives. The key innovation of our analysis is a novel notion called Gradient-Normalized Smoothness, which characterizes the maximum radius of a ball around the current point that yields a good relative approximation of the gradient field. Our theory establishes a natural intrinsic connection between Hessian approximation and the linearization of the gradient. Importantly, Gradient-Normalized Smoothness does not depend on the specific problem class of the objective functions, while effectively translating local information about the gradient field and Hessian approximation into the global behavior of the method. This new concept equips approximate second-order algorithms with universal global convergence guarantees, recovering state-of-the-art rates for functions with H\"older-continuous Hessians and third derivatives, quasi-self-concordant functions, as well as smooth classes in first-order optimization. These rates are achieved automatically and extend to broader classes, such as generalized self-concordant functions. We demonstrate direct applications of our results for global linear rates in logistic regression and softmax problems with approximate Hessians, as well as in non-convex optimization using Fisher and Gauss-Newton approximations.

  • 3 authors
·
Jun 16, 2025

DiagEvo: Diagnosis-Guided Self-Evolution via Hierarchical Error Memory

Self-play is an effective paradigm for language-model self-evolution, but without guidance, solver performance can plateau or decline across rounds. Unguided methods steer question generation with signals such as difficulty, learnability, or diversity. These signals keep questions challenging and varied but do not specify which unresolved reasoning weaknesses later rounds should target. Guided methods obtain direction from external task resources, including human examples, document corpora, or specified difficulty targets, and therefore rely on task information supplied outside the self-play loop. We show that the needed direction can instead be derived from the solver's own failure history. We introduce DiagEvo, whose diagnostician extracts recurring error causes from this history and stores them in a hierarchical error-cause memory. The memory groups related causes under skill nodes and tracks each as Active or Mastered according to self-consistency on targeted questions. The challenger uses these states and recurrence counts to balance cause-targeted generation with free exploration. Double-confidence filtering retains intermediate-difficulty questions only when the most common solver answer has a clear vote lead. DiagEvo derives its curriculum from information produced during self-play, without external task resources. With the default 4B diagnostician, DiagEvo outperforms every baseline in mean accuracy across all nine benchmarks for each of the three solvers: Qwen3-4B, Qwen3-8B, and OctoThinker-8B. On Qwen3-8B, it reaches 72.3% mean accuracy across five mathematical reasoning benchmarks, 4.5 percentage points above R-Zero. Its mean accuracy across all nine benchmarks is 57.4%, 1.1 percentage points above DARC. Ablations show that the hierarchical error-cause memory and double-confidence filtering both contribute to these gains.

meituan-longcat LongCat
·
Aug 31 2

RAPTOR: Ridge-Adaptive Logistic Probes

Probing studies what information is encoded in a frozen LLM's layer representations by training a lightweight predictor on top of them. Beyond analysis, probes are often used operationally in probe-then-steer pipelines: a learned concept vector is extracted from a probe and injected via additive activation steering by adding it to a layer representation during the forward pass. The effectiveness of this pipeline hinges on estimating concept vectors that are accurate, directionally stable under ablation, and inexpensive to obtain. Motivated by these desiderata, we propose RAPTOR (Ridge-Adaptive Logistic Probe), a simple L2-regularized logistic probe whose validation-tuned ridge strength yields concept vectors from normalized weights. Across extensive experiments on instruction-tuned LLMs and human-written concept datasets, RAPTOR matches or exceeds strong baselines in accuracy while achieving competitive directional stability and substantially lower training cost; these quantitative results are supported by qualitative downstream steering demonstrations. Finally, using the Convex Gaussian Min-max Theorem (CGMT), we provide a mechanistic characterization of ridge logistic regression in an idealized Gaussian teacher-student model in the high-dimensional few-shot regime, explaining how penalty strength mediates probe accuracy and concept-vector stability and yielding structural predictions that qualitatively align with trends observed on real LLM embeddings.

Eliminating Oversaturation and Artifacts of High Guidance Scales in Diffusion Models

Classifier-free guidance (CFG) is crucial for improving both generation quality and alignment between the input condition and final output in diffusion models. While a high guidance scale is generally required to enhance these aspects, it also causes oversaturation and unrealistic artifacts. In this paper, we revisit the CFG update rule and introduce modifications to address this issue. We first decompose the update term in CFG into parallel and orthogonal components with respect to the conditional model prediction and observe that the parallel component primarily causes oversaturation, while the orthogonal component enhances image quality. Accordingly, we propose down-weighting the parallel component to achieve high-quality generations without oversaturation. Additionally, we draw a connection between CFG and gradient ascent and introduce a new rescaling and momentum method for the CFG update rule based on this insight. Our approach, termed adaptive projected guidance (APG), retains the quality-boosting advantages of CFG while enabling the use of higher guidance scales without oversaturation. APG is easy to implement and introduces practically no additional computational overhead to the sampling process. Through extensive experiments, we demonstrate that APG is compatible with various conditional diffusion models and samplers, leading to improved FID, recall, and saturation scores while maintaining precision comparable to CFG, making our method a superior plug-and-play alternative to standard classifier-free guidance.

  • 3 authors
·
Oct 3, 2024 8

SHOVIR: A Benchmark for Evaluating Vision Shortcut Learning in Radiology Report Generation

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image. This allows models to achieve competitive scores by exploiting learned priors or spurious correlations, a failure mode we refer to as vision shortcut. We introduce SHOVIR, a benchmark for evaluating vision shortcut behavior in RRG. SHOVIR extends two spatially annotated chest X-ray datasets, MIMIC-CXR and PadChest-GR, with per-box CheXpert labels, and defines image-level and disease-level occlusion experiments that contrast baseline performance on clean images against localized, region-specific perturbations. Comparing predictions across these conditions isolates two failure modes at the disease-class level: direct shortcuts, where a finding persists after its visual evidence is removed, and contextual shortcuts, where detection degrades once co-occurring pathologies are occluded despite the target region remaining intact. Benchmarking eight state-of-the-art VLMs, we find that shortcut behavior varies substantially across architectures and datasets. Models achieving the highest baseline report quality do not necessarily rank highest in spatial grounding, revealing that clinically fluent generation can coexist with shallow reliance on visual evidence. These findings expose a blind spot in current RRG evaluation and motivate region-aware assessment protocols.

  • 5 authors
·
Jun 28

End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

  • 10 authors
·
Aug 21, 2025 2

An Explainable Diagnostic Framework for Neurodegenerative Dementias via Reinforcement-Optimized LLM Reasoning

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

  • 6 authors
·
May 26, 2025 2

Sequential Training of Neural Networks with Gradient Boosting

This paper presents a novel technique based on gradient boosting to train the final layers of a neural network (NN). Gradient boosting is an additive expansion algorithm in which a series of models are trained sequentially to approximate a given function. A neural network can also be seen as an additive expansion where the scalar product of the responses of the last hidden layer and its weights provide the final output of the network. Instead of training the network as a whole, the proposed algorithm trains the network sequentially in T steps. First, the bias term of the network is initialized with a constant approximation that minimizes the average loss of the data. Then, at each step, a portion of the network, composed of J neurons, is trained to approximate the pseudo-residuals on the training data computed from the previous iterations. Finally, the T partial models and bias are integrated as a single NN with T times J neurons in the hidden layer. Extensive experiments in classification and regression tasks, as well as in combination with deep neural networks, are carried out showing a competitive generalization performance with respect to neural networks trained with different standard solvers, such as Adam, L-BFGS, SGD and deep models. Furthermore, we show that the proposed method design permits to switch off a number of hidden units during test (the units that were last trained) without a significant reduction of its generalization ability. This permits the adaptation of the model to different classification speed requirements on the fly.

  • 2 authors
·
Sep 26, 2019

The Laws of Context Allocation: Causal Measurement and Closed-Loop Orchestration in Generative Search

As Retrieval-Augmented Generation (RAG) shifts toward diverse portfolio generation, it is stymied by two critical bottlenecks: flawed measurement of evidence utilization, and suboptimal context budget allocation. We resolve both sequentially. To resolve measurement, we expose a pervasive ``diagnostic illusion'': standard relevance proxies fail catastrophically on hard negatives. We replace them with an efficient causal leave-one-out probe that accurately isolates generative reliance and formally calibrates the structural dilution of LLM attention. To resolve allocation, we deploy this causal probe in a deconfounded factorial grid. We prove that the prevailing strategy of monolithic context widening is an architectural trap penalized by relevance decay. Instead, allocating compute iteratively across multiple sequential generations drives transformative portfolio recall gains of 16.7--20.5 absolute percentage points, scaling robustly up to 32B models. Finally, we unify these solutions into a deployable closed-loop submodular scheduler. Augmented by an attribution-steered contrastive decoder to override LLM attention inertia, our architecture systematically forces fresh evidence integration. By dominating classical open-loop baselines, we establish sequential, feedback-driven orchestration as the definitive paradigm for generative search. Our code, data, and causal measurement instruments are available at https://github.com/PeiYangLiu/ascp.

DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Models

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

  • 8 authors
·
May 20, 2025

Sequential Gradient Coding For Straggler Mitigation

In distributed computing, slower nodes (stragglers) usually become a bottleneck. Gradient Coding (GC), introduced by Tandon et al., is an efficient technique that uses principles of error-correcting codes to distribute gradient computation in the presence of stragglers. In this paper, we consider the distributed computation of a sequence of gradients {g(1),g(2),ldots,g(J)}, where processing of each gradient g(t) starts in round-t and finishes by round-(t+T). Here Tgeq 0 denotes a delay parameter. For the GC scheme, coding is only across computing nodes and this results in a solution where T=0. On the other hand, having T>0 allows for designing schemes which exploit the temporal dimension as well. In this work, we propose two schemes that demonstrate improved performance compared to GC. Our first scheme combines GC with selective repetition of previously unfinished tasks and achieves improved straggler mitigation. In our second scheme, which constitutes our main contribution, we apply GC to a subset of the tasks and repetition for the remainder of the tasks. We then multiplex these two classes of tasks across workers and rounds in an adaptive manner, based on past straggler patterns. Using theoretical analysis, we demonstrate that our second scheme achieves significant reduction in the computational load. In our experiments, we study a practical setting of concurrently training multiple neural networks over an AWS Lambda cluster involving 256 worker nodes, where our framework naturally applies. We demonstrate that the latter scheme can yield a 16\% improvement in runtime over the baseline GC scheme, in the presence of naturally occurring, non-simulated stragglers.

  • 3 authors
·
Nov 24, 2022

Weakly Supervised Lesion Detection and Diagnosis for Breast Cancers with Partially Annotated Ultrasound Images

Deep learning (DL) has proven highly effective for ultrasound-based computer-aided diagnosis (CAD) of breast cancers. In an automaticCAD system, lesion detection is critical for the following diagnosis. However, existing DL-based methods generally require voluminous manually-annotated region of interest (ROI) labels and class labels to train both the lesion detection and diagnosis models. In clinical practice, the ROI labels, i.e. ground truths, may not always be optimal for the classification task due to individual experience of sonologists, resulting in the issue of coarse annotation that limits the diagnosis performance of a CAD model. To address this issue, a novel Two-Stage Detection and Diagnosis Network (TSDDNet) is proposed based on weakly supervised learning to enhance diagnostic accuracy of the ultrasound-based CAD for breast cancers. In particular, all the ROI-level labels are considered as coarse labels in the first training stage, and then a candidate selection mechanism is designed to identify optimallesion areas for both the fully and partially annotated samples. It refines the current ROI-level labels in the fully annotated images and the detected ROIs in the partially annotated samples with a weakly supervised manner under the guidance of class labels. In the second training stage, a self-distillation strategy further is further proposed to integrate the detection network and classification network into a unified framework as the final CAD model for joint optimization, which then further improves the diagnosis performance. The proposed TSDDNet is evaluated on a B-mode ultrasound dataset, and the experimental results show that it achieves the best performance on both lesion detection and diagnosis tasks, suggesting promising application potential.

  • 9 authors
·
Jun 12, 2023

Cumulative-Goodness Free-Riding in Forward-Forward Networks: Real, Repairable, but Not Accuracy-Dominant

Forward-Forward (FF) training allows each layer to learn from a local goodness criterion. In cumulative-goodness variants, however, later layers can inherit a task that earlier layers have already partially separated. We formalize this phenomenon as layer free-riding: under the softplus FF criterion, the class-discrimination gradient reaching block d decays exponentially with the positive margin accumulated by preceding blocks. We then study three local remedies -- per-block, hardness-gated, and depth-scaled -- that recover current-layer separation measures without relying on backpropagated gradients. On CIFAR-10 and CIFAR-100, these remedies dramatically improve layer-separation statistics, with 4times--45times gains in deeper layers, while changing accuracy by less than one percentage point for non-degenerate training procedures. Tiny ImageNet provides a tougher cross-dataset check for our selected block-wise configuration and reveals the same qualitative gap between layer-health diagnostics and final accuracy. Calibration experiments further show that architecture and augmentation choices have a larger effect on final accuracy than the training-rule modifications studied here. Cumulative free-riding is therefore a real and repairable optimization pathology. Nonetheless, for the FF training rules, architectures, and datasets we study, it is not the dominant factor limiting achievable accuracy.

  • 1 authors
·
May 6

RAD: Towards Trustworthy Retrieval-Augmented Multi-modal Clinical Diagnosis

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Fudan-University Fudan University
·
Sep 24, 2025

TrAct: Making First-layer Pre-Activations Trainable

We consider the training of the first layer of vision models and notice the clear relationship between pixel values and gradient update magnitudes: the gradients arriving at the weights of a first layer are by definition directly proportional to (normalized) input pixel values. Thus, an image with low contrast has a smaller impact on learning than an image with higher contrast, and a very bright or very dark image has a stronger impact on the weights than an image with moderate brightness. In this work, we propose performing gradient descent on the embeddings produced by the first layer of the model. However, switching to discrete inputs with an embedding layer is not a reasonable option for vision models. Thus, we propose the conceptual procedure of (i) a gradient descent step on first layer activations to construct an activation proposal, and (ii) finding the optimal weights of the first layer, i.e., those weights which minimize the squared distance to the activation proposal. We provide a closed form solution of the procedure and adjust it for robust stochastic training while computing everything efficiently. Empirically, we find that TrAct (Training Activations) speeds up training by factors between 1.25x and 4x while requiring only a small computational overhead. We demonstrate the utility of TrAct with different optimizers for a range of different vision models including convolutional and transformer architectures.

  • 3 authors
·
Oct 31, 2024

Gradient-Free Classifier Guidance for Diffusion Model Sampling

Image generation using diffusion models have demonstrated outstanding learning capabilities, effectively capturing the full distribution of the training dataset. They are known to generate wide variations in sampled images, albeit with a trade-off in image fidelity. Guided sampling methods, such as classifier guidance (CG) and classifier-free guidance (CFG), focus sampling in well-learned high-probability regions to generate images of high fidelity, but each has its limitations. CG is computationally expensive due to the use of back-propagation for classifier gradient descent, while CFG, being gradient-free, is more efficient but compromises class label alignment compared to CG. In this work, we propose an efficient guidance method that fully utilizes a pre-trained classifier without using gradient descent. By using the classifier solely in inference mode, a time-adaptive reference class label and corresponding guidance scale are determined at each time step for guided sampling. Experiments on both class-conditioned and text-to-image generation diffusion models demonstrate that the proposed Gradient-free Classifier Guidance (GFCG) method consistently improves class prediction accuracy. We also show GFCG to be complementary to other guided sampling methods like CFG. When combined with the state-of-the-art Autoguidance (ATG), without additional computational overhead, it enhances image fidelity while preserving diversity. For ImageNet 512times512, we achieve a record FD_{DINOv2} of 23.09, while simultaneously attaining a higher classification Precision (94.3%) compared to ATG (90.2%)

  • 7 authors
·
Nov 22, 2024

Skin Lesion Classification Using CNNs with Patch-Based Attention and Diagnosis-Guided Loss Weighting

Objective: This work addresses two key problems of skin lesion classification. The first problem is the effective use of high-resolution images with pretrained standard architectures for image classification. The second problem is the high class imbalance encountered in real-world multi-class datasets. Methods: To use high-resolution images, we propose a novel patch-based attention architecture that provides global context between small, high-resolution patches. We modify three pretrained architectures and study the performance of patch-based attention. To counter class imbalance problems, we compare oversampling, balanced batch sampling, and class-specific loss weighting. Additionally, we propose a novel diagnosis-guided loss weighting method which takes the method used for ground-truth annotation into account. Results: Our patch-based attention mechanism outperforms previous methods and improves the mean sensitivity by 7%. Class balancing significantly improves the mean sensitivity and we show that our diagnosis-guided loss weighting method improves the mean sensitivity by 3% over normal loss balancing. Conclusion: The novel patch-based attention mechanism can be integrated into pretrained architectures and provides global context between local patches while outperforming other patch-based methods. Hence, pretrained architectures can be readily used with high-resolution images without downsampling. The new diagnosis-guided loss weighting method outperforms other methods and allows for effective training when facing class imbalance. Significance: The proposed methods improve automatic skin lesion classification. They can be extended to other clinical applications where high-resolution image data and class imbalance are relevant.

  • 8 authors
·
May 8, 2019

Adaptive Guidance: Training-free Acceleration of Conditional Diffusion Models

This paper presents a comprehensive study on the role of Classifier-Free Guidance (CFG) in text-conditioned diffusion models from the perspective of inference efficiency. In particular, we relax the default choice of applying CFG in all diffusion steps and instead search for efficient guidance policies. We formulate the discovery of such policies in the differentiable Neural Architecture Search framework. Our findings suggest that the denoising steps proposed by CFG become increasingly aligned with simple conditional steps, which renders the extra neural network evaluation of CFG redundant, especially in the second half of the denoising process. Building upon this insight, we propose "Adaptive Guidance" (AG), an efficient variant of CFG, that adaptively omits network evaluations when the denoising process displays convergence. Our experiments demonstrate that AG preserves CFG's image quality while reducing computation by 25%. Thus, AG constitutes a plug-and-play alternative to Guidance Distillation, achieving 50% of the speed-ups of the latter while being training-free and retaining the capacity to handle negative prompts. Finally, we uncover further redundancies of CFG in the first half of the diffusion process, showing that entire neural function evaluations can be replaced by simple affine transformations of past score estimates. This method, termed LinearAG, offers even cheaper inference at the cost of deviating from the baseline model. Our findings provide insights into the efficiency of the conditional denoising process that contribute to more practical and swift deployment of text-conditioned diffusion models.

  • 8 authors
·
Dec 19, 2023

PathScale-R1: Cross-scale Reasoning for Pathological Image Analysis

Pathological diagnosis is inherently multi-scale, requiring the integration of global tissue architecture at low magnification with cellular morphology at higher magnification. However, existing pathology benchmarks and vision-language models (VLMs) are still largely developed under single-scale settings, limiting their ability to learn clinically meaningful multi-magnification reasoning. Moreover, naively constructed visual question answering (VQA) tasks may be susceptible to text-only or superficial visual shortcuts, leading to unreliable assessments of visual understanding. To address these limitations, we introduce a benchmark and training framework for shortcut-resistant cross-scale pathology reasoning. We design an Adversarial Text-only Screening strategy for semantic reasoning questions and a Structure-controlled Distractor Sampling strategy for visual grounding questions, encouraging models to rely on cross-scale visual evidence. Based on this pipeline, we construct PathScale-VQA, a high-quality cross-scale pathology VQA benchmark with 10,373 multiple-choice questions grounded in 1,368 diagnostic paths across multiple magnification levels. Building on the semantic reasoning set, PathScale-R1 is optimized through Difficulty-driven Reasoning Distillation supervised fine-tuning followed by reinforcement learning with a Scale-aware Reasoning Structure reward, which encourages the use of evidence across magnifications. Extensive experiments demonstrate state-of-the-art performance of PathScale-R1 on cross-scale reasoning tasks and effective transfer to conventional single-scale pathology VQA. Our code is available at https://github.com/iMVR-PL/PathScale-R1.

  • 10 authors
·
Jul 25

Root-Cause Attribution Is a Search Problem: Continual Search for Long-Horizon Agent Failures

The increasing deployment of AI agents in long-horizon tasks yields massive execution logs. Diagnosing failures within these records is crucial for reliability, as it transforms outcome-level signals into actionable interventions. The sheer scale of the data renders human review impractical, driving the need for automated root-cause attribution (RCA). However, automated RCA methods using LLMs suffer from low diagnostic accuracy, especially as execution traces grow larger. They struggle because relevant information is often sparse, distributed across distant actions, and disconnected from the visible failure, reducing root-cause attribution to a massive search problem. Existing RCA methods typically rely on one-shot LLM judgments to diagnose failures from execution traces. While effective for shorter trajectories, these judges tend to settle on a plausible diagnosis early, leaving critical evidence in longer traces unexamined. We introduce Continual Search, an iterative framework that nudges the judge, over successive turns, to keep searching for unresolved diagnostic evidence. We evaluate Continual Search across four existing RCA benchmarks. Recognizing the lack of massive execution traces in current benchmarks, we introduce MegaRCA-Mix to evaluate RCA at scale. MegaRCA-Mix provides a challenging testbed of 50 human-annotated failure trials spanning long-horizon, execution-heavy tasks. Across multiple benchmark suites and model families, Continual Search consistently improves attribution performance. On MegaRCA-Mix, for example, it improves GPT-5.5's F1 score by more than 40\%, from 0.349 to 0.498. More interestingly, within the same model family, lower-tier models can even surpass their higher-tier counterparts, demonstrating that effective search supersedes raw model scale.

ScaleAI Scale AI
·
Sep 10 2

SkinFlow: Efficient Information Transmission for Open Dermatological Diagnosis via Dynamic Visual Encoding and Staged RL

General-purpose Large Vision-Language Models (LVLMs), despite their massive scale, often falter in dermatology due to "diffuse attention" - the inability to disentangle subtle pathological lesions from background noise. In this paper, we challenge the assumption that parameter scaling is the only path to medical precision. We introduce SkinFlow, a framework that treats diagnosis as an optimization of visual information transmission efficiency. Our approach utilizes a Virtual-Width Dynamic Vision Encoder (DVE) to "unfold" complex pathological manifolds without physical parameter expansion, coupled with a two-stage Reinforcement Learning strategy. This strategy sequentially aligns explicit medical descriptions (Stage I) and reconstructs implicit diagnostic textures (Stage II) within a constrained semantic space. Furthermore, we propose a clinically grounded evaluation protocol that prioritizes diagnostic safety and hierarchical relevance over rigid label matching. Empirical results are compelling: our 7B model establishes a new state-of-the-art on the Fitzpatrick17k benchmark, achieving a +12.06% gain in Top-1 accuracy and a +28.57% boost in Top-6 accuracy over the massive general-purpose models (e.g., Qwen3VL-235B and GPT-5.2). These findings demonstrate that optimizing geometric capacity and information flow yields superior diagnostic reasoning compared to raw parameter scaling.

An Integrated Optimization and Machine Learning Models to Predict the Admission Status of Emergency Patients

This work proposes a framework for optimizing machine learning algorithms. The practicality of the framework is illustrated using an important case study from the healthcare domain, which is predicting the admission status of emergency department (ED) patients (e.g., admitted vs. discharged) using patient data at the time of triage. The proposed framework can mitigate the crowding problem by proactively planning the patient boarding process. A large retrospective dataset of patient records is obtained from the electronic health record database of all ED visits over three years from three major locations of a healthcare provider in the Midwest of the US. Three machine learning algorithms are proposed: T-XGB, T-ADAB, and T-MLP. T-XGB integrates extreme gradient boosting (XGB) and Tabu Search (TS), T-ADAB integrates Adaboost and TS, and T-MLP integrates multi-layer perceptron (MLP) and TS. The proposed algorithms are compared with the traditional algorithms: XGB, ADAB, and MLP, in which their parameters are tunned using grid search. The three proposed algorithms and the original ones are trained and tested using nine data groups that are obtained from different feature selection methods. In other words, 54 models are developed. Performance was evaluated using five measures: Area under the curve (AUC), sensitivity, specificity, F1, and accuracy. The results show that the newly proposed algorithms resulted in high AUC and outperformed the traditional algorithms. The T-ADAB performs the best among the newly developed algorithms. The AUC, sensitivity, specificity, F1, and accuracy of the best model are 95.4%, 99.3%, 91.4%, 95.2%, 97.2%, respectively.

  • 4 authors
·
Feb 18, 2022

Sequential Diagnosis with Language Models

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

  • 15 authors
·
Jun 27, 2025

Automatic Differential Diagnosis using Transformer-Based Multi-Label Sequence Classification

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

  • 3 authors
·
Aug 28, 2024 1

Understanding and mitigating gradient pathologies in physics-informed neural networks

The widespread use of neural networks across different scientific domains often involves constraining them to satisfy certain symmetries, conservation laws, or other domain knowledge. Such constraints are often imposed as soft penalties during model training and effectively act as domain-specific regularizers of the empirical risk loss. Physics-informed neural networks is an example of this philosophy in which the outputs of deep neural networks are constrained to approximately satisfy a given set of partial differential equations. In this work we review recent advances in scientific machine learning with a specific focus on the effectiveness of physics-informed neural networks in predicting outcomes of physical systems and discovering hidden physics from noisy data. We will also identify and analyze a fundamental mode of failure of such approaches that is related to numerical stiffness leading to unbalanced back-propagated gradients during model training. To address this limitation we present a learning rate annealing algorithm that utilizes gradient statistics during model training to balance the interplay between different terms in composite loss functions. We also propose a novel neural network architecture that is more resilient to such gradient pathologies. Taken together, our developments provide new insights into the training of constrained neural networks and consistently improve the predictive accuracy of physics-informed neural networks by a factor of 50-100x across a range of problems in computational physics. All code and data accompanying this manuscript are publicly available at https://github.com/PredictiveIntelligenceLab/GradientPathologiesPINNs.

  • 3 authors
·
Jan 12, 2020

There and Back Again: Revisiting Backpropagation Saliency Methods

Saliency methods seek to explain the predictions of a model by producing an importance map across each input sample. A popular class of such methods is based on backpropagating a signal and analyzing the resulting gradient. Despite much research on such methods, relatively little work has been done to clarify the differences between such methods as well as the desiderata of these techniques. Thus, there is a need for rigorously understanding the relationships between different methods as well as their failure modes. In this work, we conduct a thorough analysis of backpropagation-based saliency methods and propose a single framework under which several such methods can be unified. As a result of our study, we make three additional contributions. First, we use our framework to propose NormGrad, a novel saliency method based on the spatial contribution of gradients of convolutional weights. Second, we combine saliency maps at different layers to test the ability of saliency methods to extract complementary information at different network levels (e.g.~trading off spatial resolution and distinctiveness) and we explain why some methods fail at specific layers (e.g., Grad-CAM anywhere besides the last convolutional layer). Third, we introduce a class-sensitivity metric and a meta-learning inspired paradigm applicable to any saliency method for improving sensitivity to the output class being explained.

  • 4 authors
·
Apr 6, 2020

When, Why and How Much? Adaptive Learning Rate Scheduling by Refinement

Learning rate schedules used in practice bear little resemblance to those recommended by theory. We close much of this theory/practice gap, and as a consequence are able to derive new problem-adaptive learning rate schedules. Our key technical contribution is a refined analysis of learning rate schedules for a wide class of optimization algorithms (including SGD). In contrast to most prior works that study the convergence of the average iterate, we study the last iterate, which is what most people use in practice. When considering only worst-case analysis, our theory predicts that the best choice is the linear decay schedule: a popular choice in practice that sets the stepsize proportionally to 1 - t/T, where t is the current iteration and T is the total number of steps. To go beyond this worst-case analysis, we use the observed gradient norms to derive schedules refined for any particular task. These refined schedules exhibit learning rate warm-up and rapid learning rate annealing near the end of training. Ours is the first systematic approach to automatically yield both of these properties. We perform the most comprehensive evaluation of learning rate schedules to date, evaluating across 10 diverse deep learning problems, a series of LLMs, and a suite of logistic regression problems. We validate that overall, the linear-decay schedule matches or outperforms all commonly used default schedules including cosine annealing, and that our schedule refinement method gives further improvements.

  • 4 authors
·
Oct 11, 2023

CF-CAM: Cluster Filter Class Activation Mapping for Reliable Gradient-Based Interpretability

As deep learning continues to advance, the transparency of neural network decision-making remains a critical challenge, limiting trust and applicability in high-stakes domains. Class Activation Mapping (CAM) techniques have emerged as a key approach toward visualizing model decisions, yet existing methods face inherent trade-offs. Gradient-based CAM variants suffer from sensitivity to gradient perturbations due to gradient noise, leading to unstable and unreliable explanations. Conversely, gradient-free approaches mitigate gradient instability but incur significant computational overhead and inference latency. To address these limitations, we propose a Cluster Filter Class Activation Map (CF-CAM) technique, a novel framework that reintroduces gradient-based weighting while enhancing robustness against gradient noise. CF-CAM utilizes hierarchical importance weighting strategy to balance discriminative feature preservation and noise elimination. A density-aware channel clustering method via Density-Based Spatial Clustering of Applications with Noise (DBSCAN) groups semantically relevant feature channels and discard noise-prone activations. Additionally, cluster-conditioned gradient filtering leverages Gaussian filters to refine gradient signals, preserving edge-aware localization while suppressing noise impact. Experiment results demonstrate that CF-CAM achieves superior interpretability performance while enhancing computational efficiency, outperforming state-of-the-art CAM methods in faithfulness and robustness. By effectively mitigating gradient instability without excessive computational cost, CF-CAM provides a competitive solution for enhancing the interpretability of deep neural networks in critical applications such as autonomous driving and medical diagnosis.

  • 3 authors
·
Mar 31, 2025

Improving Classifier-Free Guidance of Flow Matching via Manifold Projection

Classifier-free guidance (CFG) is a widely used technique for controllable generation in diffusion and flow-based models. Despite its empirical success, CFG relies on a heuristic linear extrapolation that is often sensitive to the guidance scale. In this work, we provide a principled interpretation of CFG through the lens of optimization. We demonstrate that the velocity field in flow matching corresponds to the gradient of a sequence of smoothed distance functions, which guides latent variables toward the scaled target image set. This perspective reveals that the standard CFG formulation is an approximation of this gradient, where the prediction gap, the discrepancy between conditional and unconditional outputs, governs guidance sensitivity. Leveraging this insight, we reformulate the CFG sampling as a homotopy optimization with a manifold constraint. This formulation necessitates a manifold projection step, which we implement via an incremental gradient descent scheme during sampling. To improve computational efficiency and stability, we further enhance this iterative process with Anderson Acceleration without requiring additional model evaluations. Our proposed methods are training-free and consistently refine generation fidelity, prompt alignment, and robustness to the guidance scale. We validate their effectiveness across diverse benchmarks, demonstrating significant improvements on large-scale models such as DiT-XL-2-256, Flux, and Stable Diffusion 3.5.

  • 4 authors
·
Jan 29

PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

  • 4 authors
·
Aug 24, 2023

Attention Saturation and Gradient Suppression at Inflection Layers: Diagnosing and Mitigating Bottlenecks in Transformer Adaptation

Pre-trained Transformers often exhibit over-confidence in source patterns and difficulty in forming new target-domain patterns during fine-tuning. We formalize the mechanism of output saturation leading to gradient suppression through standard cross-entropy and softmax analysis, showing that gradient suppression at inflection layers confines adaptation to high-level recombination of existing features while preventing low-level reconstruction. We introduce a set of layer-wise diagnostic metrics -- attention entropy (saturation proxy), activation gradient norm, parameter gradient norm, and Delta-CKA under a shared PCA basis -- to identify inflection layers characterized by both low attention entropy and steep gradient decay. Building on these findings, we propose a diagnose-first, inject-light fine-tuning strategy: selectively inserting LoRA adapters at inflection layers to restore suppressed backward signals with minimal parameter overhead. Experiments on BERT-base transfer from SST-2 to Rotten Tomatoes under under-trained and over-trained source regimes reveal that over-trained initialization benefits from inflection-layer LoRA injection, while under-trained initialization suffers performance degradation. When base features are strong, unblocking inflection layers facilitates high-level compositional adaptation; when base features are weak, full-pathway unblocking is required for low-level reconstruction, as supported by joint analysis of layer-wise activation gradients and Delta-CKA dynamics.

  • 1 authors
·
Nov 2, 2025

From Logistic Regression to the Perceptron Algorithm: Exploring Gradient Descent with Large Step Sizes

We focus on the classification problem with a separable dataset, one of the most important and classical problems from machine learning. The standard approach to this task is logistic regression with gradient descent (LR+GD). Recent studies have observed that LR+GD can find a solution with arbitrarily large step sizes, defying conventional optimization theory. Our work investigates this phenomenon and makes three interconnected key observations about LR+GD with large step sizes. First, we find a remarkably simple explanation of why LR+GD with large step sizes solves the classification problem: LR+GD reduces to a batch version of the celebrated perceptron algorithm when the step size gamma to infty. Second, we observe that larger step sizes lead LR+GD to higher logistic losses when it tends to the perceptron algorithm, but larger step sizes also lead to faster convergence to a solution for the classification problem, meaning that logistic loss is an unreliable metric of the proximity to a solution. Surprisingly, high loss values can actually indicate faster convergence. Third, since the convergence rate in terms of loss function values of LR+GD is unreliable, we examine the iteration complexity required by LR+GD with large step sizes to solve the classification problem and prove that this complexity is suboptimal. To address this, we propose a new method, Normalized LR+GD - based on the connection between LR+GD and the perceptron algorithm - with much better theoretical guarantees.

  • 1 authors
·
Dec 11, 2024

Rethinking Medical Report Generation: Disease Revealing Enhancement with Knowledge Graph

Knowledge Graph (KG) plays a crucial role in Medical Report Generation (MRG) because it reveals the relations among diseases and thus can be utilized to guide the generation process. However, constructing a comprehensive KG is labor-intensive and its applications on the MRG process are under-explored. In this study, we establish a complete KG on chest X-ray imaging that includes 137 types of diseases and abnormalities. Based on this KG, we find that the current MRG data sets exhibit a long-tailed problem in disease distribution. To mitigate this problem, we introduce a novel augmentation strategy that enhances the representation of disease types in the tail-end of the distribution. We further design a two-stage MRG approach, where a classifier is first trained to detect whether the input images exhibit any abnormalities. The classified images are then independently fed into two transformer-based generators, namely, ``disease-specific generator" and ``disease-free generator" to generate the corresponding reports. To enhance the clinical evaluation of whether the generated reports correctly describe the diseases appearing in the input image, we propose diverse sensitivity (DS), a new metric that checks whether generated diseases match ground truth and measures the diversity of all generated diseases. Results show that the proposed two-stage generation framework and augmentation strategies improve DS by a considerable margin, indicating a notable reduction in the long-tailed problem associated with under-represented diseases.

  • 3 authors
·
Jul 23, 2023

Where is VALDO? VAscular Lesions Detection and segmentatiOn challenge at MICCAI 2021

Imaging markers of cerebral small vessel disease provide valuable information on brain health, but their manual assessment is time-consuming and hampered by substantial intra- and interrater variability. Automated rating may benefit biomedical research, as well as clinical assessment, but diagnostic reliability of existing algorithms is unknown. Here, we present the results of the VAscular Lesions DetectiOn and Segmentation (Where is VALDO?) challenge that was run as a satellite event at the international conference on Medical Image Computing and Computer Aided Intervention (MICCAI) 2021. This challenge aimed to promote the development of methods for automated detection and segmentation of small and sparse imaging markers of cerebral small vessel disease, namely enlarged perivascular spaces (EPVS) (Task 1), cerebral microbleeds (Task 2) and lacunes of presumed vascular origin (Task 3) while leveraging weak and noisy labels. Overall, 12 teams participated in the challenge proposing solutions for one or more tasks (4 for Task 1 - EPVS, 9 for Task 2 - Microbleeds and 6 for Task 3 - Lacunes). Multi-cohort data was used in both training and evaluation. Results showed a large variability in performance both across teams and across tasks, with promising results notably for Task 1 - EPVS and Task 2 - Microbleeds and not practically useful results yet for Task 3 - Lacunes. It also highlighted the performance inconsistency across cases that may deter use at an individual level, while still proving useful at a population level.

  • 49 authors
·
Aug 14, 2022

Where Pretraining writes and Alignment reads: the asymmetry of Transformer weight space

Cross-entropy pretraining and preference alignment update the same transformer weights, but leave geometrically distinct traces. We characterise this asymmetry with a relative-subspace-fraction probe that tracks how weight deltas align with residual-stream activation subspaces and with the prediction subspace defined by the unembedding. Alignment deltas concentrate in the read pathway (W_Q, W_K), along principal directions of attention-input activations, while remaining near-isotropic in the write pathway (W_O, W_2) relative to the prediction subspace. We explain this pattern through anisotropic gradient accumulation: updates to a matrix W are sums of outer products δ_t a_t^top, and inherit directional structure from whichever side has concentrated covariance. For read-pathway matrices, this side is the input activation a_t, whose covariance is spiked in trained transformers and therefore produces objective-agnostic concentration. For write-pathway matrices, the relevant side is the upstream gradient δ_t, whose anisotropy depends on the loss. Cross-entropy supplies the canonical sharp per-sample signal, inducing write-pathway prediction geometry during pretraining; alignment objectives typically add little further write-side concentration. We support this explanation with a within-checkpoint trajectory, a graded contrastive-objective control, and a closed-form rank-1 intervention with matched direction controls, providing causal evidence for the proposed weight-space geometry.

  • 3 authors
·
May 14

RareBench: Can LLMs Serve as Rare Diseases Specialists?

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

  • 6 authors
·
Feb 9, 2024

Optimization by Directional Attacks: Solving Problems with Neural Network Surrogates

This paper tackles optimization problems whose objective and constraints involve a trained Neural Network (NN), where the goal is to maximize f(Phi(x)) subject to c(Phi(x)) leq 0, with f smooth, c general and non-stringent, and Phi an already trained and possibly nonwhite-box NN. We address two challenges regarding this problem: identifying ascent directions for local search, and ensuring reliable convergence towards relevant local solutions. To this end, we re-purpose the notion of directional NN attacks as efficient optimization subroutines, since directional NN attacks use the neural structure of Phi to compute perturbations of x that steer Phi(x) in prescribed directions. Precisely, we develop an attack operator that computes attacks of Phi at any x along the direction nabla f(Phi(x)). Then, we propose a hybrid algorithm combining the attack operator with derivative-free optimization (DFO) techniques, designed for numerical reliability by remaining oblivious to the structure of the problem. We consider the cDSM algorithm, which offers asymptotic guarantees to converge to a local solution under mild assumptions on the problem. The resulting method alternates between attack-based steps for heuristic yet fast local intensification and cDSM steps for certified convergence and numerical reliability. Experiments on three problems show that this hybrid approach consistently outperforms standard DFO baselines.

  • 2 authors
·
Oct 1, 2025

Improving Diffusion Generalization with Weak-to-Strong Segmented Guidance

Diffusion models generate synthetic images through an iterative refinement process. However, the misalignment between the simulation-free objective and the iterative process often causes accumulated gradient error along the sampling trajectory, which leads to unsatisfactory results and a failure to generalize. Guidance techniques like Classifier Free Guidance (CFG) and AutoGuidance (AG) alleviate this by extrapolating between the main and inferior signal for stronger generalization. Despite empirical success, the effective operational regimes of prevalent guidance methods are still under-explored, leading to ambiguity when selecting the appropriate guidance method given a precondition. In this work, we first conduct synthetic comparisons to isolate and demonstrate the effective regime of guidance methods represented by CFG and AG from the perspective of weak-to-strong principle. Based on this, we propose a hybrid instantiation called SGG under the principle, taking the benefits of both. Furthermore, we demonstrate that the W2S principle along with SGG can be migrated into the training objective, improving the generalization ability of unguided diffusion models. We validate our approach with comprehensive experiments. At inference time, evaluations on SD3 and SD3.5 confirm that SGG outperforms existing training-free guidance variants. Training-time experiments on transformer architectures demonstrate the effective migration and performance gains in both conditional and unconditional settings. Code is available at https://github.com/851695e35/SGG.

  • 8 authors
·
Mar 20

The Medical Segmentation Decathlon

International challenges have become the de facto standard for comparative assessment of image analysis algorithms given a specific task. Segmentation is so far the most widely investigated medical image processing task, but the various segmentation challenges have typically been organized in isolation, such that algorithm development was driven by the need to tackle a single specific clinical problem. We hypothesized that a method capable of performing well on multiple tasks will generalize well to a previously unseen task and potentially outperform a custom-designed solution. To investigate the hypothesis, we organized the Medical Segmentation Decathlon (MSD) - a biomedical image analysis challenge, in which algorithms compete in a multitude of both tasks and modalities. The underlying data set was designed to explore the axis of difficulties typically encountered when dealing with medical images, such as small data sets, unbalanced labels, multi-site data and small objects. The MSD challenge confirmed that algorithms with a consistent good performance on a set of tasks preserved their good average performance on a different set of previously unseen tasks. Moreover, by monitoring the MSD winner for two years, we found that this algorithm continued generalizing well to a wide range of other clinical problems, further confirming our hypothesis. Three main conclusions can be drawn from this study: (1) state-of-the-art image segmentation algorithms are mature, accurate, and generalize well when retrained on unseen tasks; (2) consistent algorithmic performance across multiple tasks is a strong surrogate of algorithmic generalizability; (3) the training of accurate AI segmentation models is now commoditized to non AI experts.

  • 59 authors
·
Jun 10, 2021

TextGrad: Automatic "Differentiation" via Text

AI is undergoing a paradigm shift, with breakthroughs achieved by systems orchestrating multiple large language models (LLMs) and other complex components. As a result, developing principled and automated optimization methods for compound AI systems is one of the most important new challenges. Neural networks faced a similar challenge in its early days until backpropagation and automatic differentiation transformed the field by making optimization turn-key. Inspired by this, we introduce TextGrad, a powerful framework performing automatic ``differentiation'' via text. TextGrad backpropagates textual feedback provided by LLMs to improve individual components of a compound AI system. In our framework, LLMs provide rich, general, natural language suggestions to optimize variables in computation graphs, ranging from code snippets to molecular structures. TextGrad follows PyTorch's syntax and abstraction and is flexible and easy-to-use. It works out-of-the-box for a variety of tasks, where the users only provide the objective function without tuning components or prompts of the framework. We showcase TextGrad's effectiveness and generality across a diverse range of applications, from question answering and molecule optimization to radiotherapy treatment planning. Without modifying the framework, TextGrad improves the zero-shot accuracy of GPT-4o in Google-Proof Question Answering from 51% to 55%, yields 20% relative performance gain in optimizing LeetCode-Hard coding problem solutions, improves prompts for reasoning, designs new druglike small molecules with desirable in silico binding, and designs radiation oncology treatment plans with high specificity. TextGrad lays a foundation to accelerate the development of the next-generation of AI systems.

  • 7 authors
·
Jun 11, 2024

Let's Make Block Coordinate Descent Converge Faster: Faster Greedy Rules, Message-Passing, Active-Set Complexity, and Superlinear Convergence

Block coordinate descent (BCD) methods are widely used for large-scale numerical optimization because of their cheap iteration costs, low memory requirements, amenability to parallelization, and ability to exploit problem structure. Three main algorithmic choices influence the performance of BCD methods: the block partitioning strategy, the block selection rule, and the block update rule. In this paper we explore all three of these building blocks and propose variations for each that can significantly improve the progress made by each BCD iteration. We (i) propose new greedy block-selection strategies that guarantee more progress per iteration than the Gauss-Southwell rule; (ii) explore practical issues like how to implement the new rules when using "variable" blocks; (iii) explore the use of message-passing to compute matrix or Newton updates efficiently on huge blocks for problems with sparse dependencies between variables; and (iv) consider optimal active manifold identification, which leads to bounds on the "active-set complexity" of BCD methods and leads to superlinear convergence for certain problems with sparse solutions (and in some cases finite termination at an optimal solution). We support all of our findings with numerical results for the classic machine learning problems of least squares, logistic regression, multi-class logistic regression, label propagation, and L1-regularization.

  • 3 authors
·
Dec 23, 2017

Pressure-Testing Deception Probes in LLMs: Scaling, Robustness, and the Geometry of Deceptive Representations

Linear probes trained on LLM activations are increasingly proposed as deception-detection metrics, yet report AUROC exceeding 0.96 on clean benchmarks while collapsing under distributional shift. This paper systematically pressure-tests probe-based metrics across the Gemma 3 model family (1B-27B parameters), diagnosing why they fail rather than merely documenting that they fail. We test four hypotheses about deception encoding: (1) single linear direction, (2) multi-dimensional subspace, (3) convex conic hull, (4) entropy proxy. Our design includes cross-domain transfer matrices, multi-dimensional probe analysis with permutation null baselines, entropy-residualization tests, and distractor evaluations across 8 stylistic shifts. We find that: (a) probes achieve near-perfect AUROC (>=0.998) on clean data but collapse under stylistic shifts; style-augmented probes recover near-perfect detection (mean AUROC 0.979-0.983) on unseen styles; (b) the single-direction hypothesis is rejected (k=1 captures only 0.61-0.80 AUROC), with cross-domain transfer failure confirmed as geometric rather than layer-mismatch-driven; (c) the entropy-proxy hypothesis is rejected (max |rho|=0.454, max Delta-AUROC after residualization=0.004); and (d) deception does not form a significant linear subspace (per-domain k*=0), yet multi-dimensional probes (k>=5) recover the signal through distributed sub-threshold features. Probe fragility reflects distributional narrowness rather than an architectural limitation: style-augmented probes recover near-perfect detection at both 4B and 27B, establishing that the inverse scaling pattern is a training-distribution artifact rather than a genuine scale-dependent phenomenon.

  • 1 authors
·
May 27 2

Elucidating The Design Space of Classifier-Guided Diffusion Generation

Guidance in conditional diffusion generation is of great importance for sample quality and controllability. However, existing guidance schemes are to be desired. On one hand, mainstream methods such as classifier guidance and classifier-free guidance both require extra training with labeled data, which is time-consuming and unable to adapt to new conditions. On the other hand, training-free methods such as universal guidance, though more flexible, have yet to demonstrate comparable performance. In this work, through a comprehensive investigation into the design space, we show that it is possible to achieve significant performance improvements over existing guidance schemes by leveraging off-the-shelf classifiers in a training-free fashion, enjoying the best of both worlds. Employing calibration as a general guideline, we propose several pre-conditioning techniques to better exploit pretrained off-the-shelf classifiers for guiding diffusion generation. Extensive experiments on ImageNet validate our proposed method, showing that state-of-the-art diffusion models (DDPM, EDM, DiT) can be further improved (up to 20%) using off-the-shelf classifiers with barely any extra computational cost. With the proliferation of publicly available pretrained classifiers, our proposed approach has great potential and can be readily scaled up to text-to-image generation tasks. The code is available at https://github.com/AlexMaOLS/EluCD/tree/main.

  • 4 authors
·
Oct 17, 2023