Daily Papers

This paper presents our system description and error analysis of our entry for NLLP 2024 shared task on Legal Natural Language Inference (L-NLI) hagag2024legallenssharedtask2024. The task required classifying these relationships as entailed, contradicted, or neutral, indicating any association between the review and the complaint. Our system emerged as the winning submission, significantly outperforming other entries with a substantial margin and demonstrating the effectiveness of our approach in legal text analysis. We provide a detailed analysis of the strengths and limitations of each model and approach tested, along with a thorough error analysis and suggestions for future improvements. This paper aims to contribute to the growing field of legal NLP by offering insights into advanced techniques for natural language inference in legal contexts, making it accessible to both experts and newcomers in the field.

A critical factor in the success of decision support systems is the accurate modeling of user preferences. Psychology research has demonstrated that users often develop their preferences during the elicitation process, highlighting the pivotal role of system-user interaction in developing personalized systems. This paper introduces a novel approach, combining Large Language Models (LLMs) with Constraint Programming to facilitate interactive decision support. We study this hybrid framework through the lens of meeting scheduling, a time-consuming daily activity faced by a multitude of information workers. We conduct three studies to evaluate the novel framework, including a diary study (n=64) to characterize contextual scheduling preferences, a quantitative evaluation of the system's performance, and a user study (n=10) with a prototype system. Our work highlights the potential for a hybrid LLM and optimization approach for iterative preference elicitation and design considerations for building systems that support human-system collaborative decision-making processes.

Large language models (LLMs), particularly those with reasoning capabilities, have rapidly advanced in recent years, demonstrating significant potential across a wide range of applications. However, their deployment in healthcare, especially in disease reasoning tasks, is hindered by the challenge of acquiring expert-level cognitive data. In this paper, we introduce Citrus, a medical language model that bridges the gap between clinical expertise and AI reasoning by emulating the cognitive processes of medical experts. The model is trained on a large corpus of simulated expert disease reasoning data, synthesized using a novel approach that accurately captures the decision-making pathways of clinicians. This approach enables Citrus to better simulate the complex reasoning processes involved in diagnosing and treating medical conditions.To further address the lack of publicly available datasets for medical reasoning tasks, we release the last-stage training data, including a custom-built medical diagnostic dialogue dataset. This open-source contribution aims to support further research and development in the field. Evaluations using authoritative benchmarks such as MedQA, covering tasks in medical reasoning and language understanding, show that Citrus achieves superior performance compared to other models of similar size. These results highlight Citrus potential to significantly enhance medical decision support systems, providing a more accurate and efficient tool for clinical decision-making.

One of the most critical tasks for startups is to validate their business model. Therefore, entrepreneurs try to collect information such as feedback from other actors to assess the validity of their assumptions and make decisions. However, previous work on decisional guidance for business model validation provides no solution for the highly uncertain and complex context of earlystage startups. The purpose of this paper is, thus, to develop design principles for a Hybrid Intelligence decision support system (HI-DSS) that combines the complementary capabilities of human and machine intelligence. We follow a design science research approach to design a prototype artifact and a set of design principles. Our study provides prescriptive knowledge for HI-DSS and contributes to previous work on decision support for business models, the applications of complementary strengths of humans and machines for making decisions, and support systems for extremely uncertain decision-making problems.

AI explanations are often mentioned as a way to improve human-AI decision-making, but empirical studies have not found consistent evidence of explanations' effectiveness and, on the contrary, suggest that they can increase overreliance when the AI system is wrong. While many factors may affect reliance on AI support, one important factor is how decision-makers reconcile their own intuition -- beliefs or heuristics, based on prior knowledge, experience, or pattern recognition, used to make judgments -- with the information provided by the AI system to determine when to override AI predictions. We conduct a think-aloud, mixed-methods study with two explanation types (feature- and example-based) for two prediction tasks to explore how decision-makers' intuition affects their use of AI predictions and explanations, and ultimately their choice of when to rely on AI. Our results identify three types of intuition involved in reasoning about AI predictions and explanations: intuition about the task outcome, features, and AI limitations. Building on these, we summarize three observed pathways for decision-makers to apply their own intuition and override AI predictions. We use these pathways to explain why (1) the feature-based explanations we used did not improve participants' decision outcomes and increased their overreliance on AI, and (2) the example-based explanations we used improved decision-makers' performance over feature-based explanations and helped achieve complementary human-AI performance. Overall, our work identifies directions for further development of AI decision-support systems and explanation methods that help decision-makers effectively apply their intuition to achieve appropriate reliance on AI.

Knowledge of the medical decision process, which can be modeled as medical decision trees (MDTs), is critical to build clinical decision support systems. However, the current MDT construction methods rely heavily on time-consuming and laborious manual annotation. In this work, we propose a novel task, Text2MDT, to explore the automatic extraction of MDTs from medical texts such as medical guidelines and textbooks. We normalize the form of the MDT and create an annotated Text-to-MDT dataset in Chinese with the participation of medical experts. We investigate two different methods for the Text2MDT tasks: (a) an end-to-end framework which only relies on a GPT style large language models (LLM) instruction tuning to generate all the node information and tree structures. (b) The pipeline framework which decomposes the Text2MDT task to three subtasks. Experiments on our Text2MDT dataset demonstrate that: (a) the end-to-end method basd on LLMs (7B parameters or larger) show promising results, and successfully outperform the pipeline methods. (b) The chain-of-thought (COT) prompting method Wei2022ChainOT can improve the performance of the fine-tuned LLMs on the Text2MDT test set. (c) the lightweight pipelined method based on encoder-based pretrained models can perform comparably with LLMs with model complexity two magnititudes smaller. Our Text2MDT dataset is open-sourced at https://tianchi.aliyun.com/dataset/95414, and the source codes are open-sourced at https://github.com/michael-wzhu/text2dt.

Synthetic Data Generation (SDG) based on Artificial Intelligence (AI) can transform the way clinical medicine is delivered by overcoming privacy barriers that currently render clinical data sharing difficult. This is the key to accelerating the development of digital tools contributing to enhanced patient safety. Such tools include robust data-driven clinical decision support systems, and example-based digital training tools that will enable healthcare professionals to improve their diagnostic performance for enhanced patient safety. This study focuses on the clinical evaluation of medical SDG, with a proof-of-concept investigation on diagnosing Inflammatory Bowel Disease (IBD) using Wireless Capsule Endoscopy (WCE) images. Its scientific contributions include a) a novel protocol for the systematic Clinical Evaluation of Medical Image Synthesis (CEMIS); b) a novel variational autoencoder-based model for the generation of high-resolution synthetic WCE images; and c) a comprehensive evaluation of the synthetic images using the CEMIS protocol by 10 international WCE specialists, in terms of image quality, diversity, and realism, as well as their utility for clinical decision-making. The results show that TIDE-II generates clinically plausible, very realistic WCE images, of improved quality compared to relevant state-of-the-art generative models. Concludingly, CEMIS can serve as a reference for future research on medical image-generation techniques, while the adaptation/extension of the architecture of TIDE-II to other imaging domains can be promising.

In the last years many accurate decision support systems have been constructed as black boxes, that is as systems that hide their internal logic to the user. This lack of explanation constitutes both a practical and an ethical issue. The literature reports many approaches aimed at overcoming this crucial weakness sometimes at the cost of scarifying accuracy for interpretability. The applications in which black box decision systems can be used are various, and each approach is typically developed to provide a solution for a specific problem and, as a consequence, delineating explicitly or implicitly its own definition of interpretability and explanation. The aim of this paper is to provide a classification of the main problems addressed in the literature with respect to the notion of explanation and the type of black box system. Given a problem definition, a black box type, and a desired explanation this survey should help the researcher to find the proposals more useful for his own work. The proposed classification of approaches to open black box models should also be useful for putting the many research open questions in perspective.

As a lightweight and non-invasive imaging technique, lung ultrasound (LUS) has gained importance for assessing lung pathologies. The use of Artificial intelligence (AI) in medical decision support systems is promising due to the time- and expertise-intensive interpretation, however, due to the poor quality of existing data used for training AI models, their usability for real-world applications remains unclear. In a prospective study, we analyze data from 63 COVID-19 suspects (33 positive) collected at Maastricht University Medical Centre. Ultrasound recordings at six body locations were acquired following the BLUE protocol and manually labeled for severity of lung involvement. Several AI models were applied and trained for detection and severity of pulmonary infection. The severity of the lung infection, as assigned by human annotators based on the LUS videos, is not significantly different between COVID-19 positive and negative patients (p = 0.89). Nevertheless, the predictions of image-based AI models identify a COVID-19 infection with 65% accuracy when applied zero-shot (i.e., trained on other datasets), and up to 79% with targeted training, whereas the accuracy based on human annotations is at most 65%. Multi-modal models combining images and CBC improve significantly over image-only models. Although our analysis generally supports the value of AI in LUS assessment, the evaluated models fall short of the performance expected from previous work. We find this is due to 1) the heterogeneity of LUS datasets, limiting the generalization ability to new data, 2) the frame-based processing of AI models ignoring video-level information, and 3) lack of work on multi-modal models that can extract the most relevant information from video-, image- and variable-based inputs. To aid future research, we publish the dataset at: https://github.com/NinaWie/COVID-BLUES.

In recent years, the wood product industry has been facing a skilled labor shortage. The result is more frequent sudden failures, resulting in additional costs for these companies already operating in a very competitive market. Moreover, sawmills are challenging environments for machinery and sensors. Given that experienced machine operators may be able to diagnose defects or malfunctions, one possible way of assisting novice operators is through acoustic monitoring. As a step towards the automation of wood-processing equipment and decision support systems for machine operators, in this paper, we explore using a deep convolutional autoencoder for acoustic anomaly detection of wood planers on a new real-life dataset. Specifically, our convolutional autoencoder with skip connections (Skip-CAE) and our Skip-CAE transformer outperform the DCASE autoencoder baseline, one-class SVM, isolation forest and a published convolutional autoencoder architecture, respectively obtaining an area under the ROC curve of 0.846 and 0.875 on a dataset of real-factory planer sounds. Moreover, we show that adding skip connections and attention mechanism under the form of a transformer encoder-decoder helps to further improve the anomaly detection capabilities.

The use of artificial intelligence to enable precision medicine and decision support systems through the analysis of pathology images has the potential to revolutionize the diagnosis and treatment of cancer. Such applications will depend on models' abilities to capture the diverse patterns observed in pathology images. To address this challenge, we present Virchow, a foundation model for computational pathology. Using self-supervised learning empowered by the DINOv2 algorithm, Virchow is a vision transformer model with 632 million parameters trained on 1.5 million hematoxylin and eosin stained whole slide images from diverse tissue and specimen types, which is orders of magnitude more data than previous works. The Virchow model enables the development of a pan-cancer detection system with 0.949 overall specimen-level AUC across 17 different cancer types, while also achieving 0.937 AUC on 7 rare cancer types. The Virchow model sets the state-of-the-art on the internal and external image tile level benchmarks and slide level biomarker prediction tasks. The gains in performance highlight the importance of training on massive pathology image datasets, suggesting scaling up the data and network architecture can improve the accuracy for many high-impact computational pathology applications where limited amounts of training data are available.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

Medical Visual Question Answering (MedVQA) is a promising field for developing clinical decision support systems, yet progress is often limited by the available datasets, which can lack clinical complexity and visual diversity. To address these gaps, we introduce Kvasir-VQA-x1, a new, large-scale dataset for gastrointestinal (GI) endoscopy. Our work significantly expands upon the original Kvasir-VQA by incorporating 159,549 new question-answer pairs that are designed to test deeper clinical reasoning. We developed a systematic method using large language models to generate these questions, which are stratified by complexity to better assess a model's inference capabilities. To ensure our dataset prepares models for real-world clinical scenarios, we have also introduced a variety of visual augmentations that mimic common imaging artifacts. The dataset is structured to support two main evaluation tracks: one for standard VQA performance and another to test model robustness against these visual perturbations. By providing a more challenging and clinically relevant benchmark, Kvasir-VQA-x1 aims to accelerate the development of more reliable and effective multimodal AI systems for use in clinical settings. The dataset is fully accessible and adheres to FAIR data principles, making it a valuable resource for the wider research community. Code and data: https://github.com/Simula/Kvasir-VQA-x1 and https://huggingface.co/datasets/SimulaMet/Kvasir-VQA-x1

Foundation models in computational pathology promise to unlock the development of new clinical decision support systems and models for precision medicine. However, there is a mismatch between most clinical analysis, which is defined at the level of one or more whole slide images, and foundation models to date, which process the thousands of image tiles contained in a whole slide image separately. The requirement to train a network to aggregate information across a large number of tiles in multiple whole slide images limits these models' impact. In this work, we present a slide-level foundation model for H&E-stained histopathology, PRISM, that builds on Virchow tile embeddings and leverages clinical report text for pre-training. Using the tile embeddings, PRISM produces slide-level embeddings with the ability to generate clinical reports, resulting in several modes of use. Using text prompts, PRISM achieves zero-shot cancer detection and sub-typing performance approaching and surpassing that of a supervised aggregator model. Using the slide embeddings with linear classifiers, PRISM surpasses supervised aggregator models. Furthermore, we demonstrate that fine-tuning of the PRISM slide encoder yields label-efficient training for biomarker prediction, a task that typically suffers from low availability of training data; an aggregator initialized with PRISM and trained on as little as 10% of the training data can outperform a supervised baseline that uses all of the data.

Vertebral labelling and segmentation are two fundamental tasks in an automated spine processing pipeline. Reliable and accurate processing of spine images is expected to benefit clinical decision-support systems for diagnosis, surgery planning, and population-based analysis on spine and bone health. However, designing automated algorithms for spine processing is challenging predominantly due to considerable variations in anatomy and acquisition protocols and due to a severe shortage of publicly available data. Addressing these limitations, the Large Scale Vertebrae Segmentation Challenge (VerSe) was organised in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2019 and 2020, with a call for algorithms towards labelling and segmentation of vertebrae. Two datasets containing a total of 374 multi-detector CT scans from 355 patients were prepared and 4505 vertebrae have individually been annotated at voxel-level by a human-machine hybrid algorithm (https://osf.io/nqjyw/, https://osf.io/t98fz/). A total of 25 algorithms were benchmarked on these datasets. In this work, we present the the results of this evaluation and further investigate the performance-variation at vertebra-level, scan-level, and at different fields-of-view. We also evaluate the generalisability of the approaches to an implicit domain shift in data by evaluating the top performing algorithms of one challenge iteration on data from the other iteration. The principal takeaway from VerSe: the performance of an algorithm in labelling and segmenting a spine scan hinges on its ability to correctly identify vertebrae in cases of rare anatomical variations. The content and code concerning VerSe can be accessed at: https://github.com/anjany/verse.

In Vitro Fertilization is among the most widespread treatments for infertility. One of its main challenges is the evaluation and selection of embryo for implantation, a process with large inter- and intra-clinician variability. Deep learning based methods are gaining attention, but their opaque nature compromises their acceptance in the clinical context, where transparency in the decision making is key. In this paper we analyze the current work in the explainability of AI-assisted embryo analysis models, identifying the limitations. We also discuss how these models could be integrated in the clinical context as decision support systems, considering the needs of clinicians and patients. Finally, we propose guidelines for the sake of increasing interpretability and trustworthiness, pushing this technology forward towards established clinical practice.

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

During a geosteering operation the well path is intentionally adjusted in response to the new data acquired while drilling. To achieve consistent high-quality decisions, especially when drilling in complex environments, decision support systems can help cope with high volumes of data and interpretation complexities. They can assimilate the real-time measurements into a probabilistic earth model and use the updated model for decision recommendations. Recently, machine learning (ML) techniques have enabled a wide range of methods that redistribute computational cost from on-line to off-line calculations. In this paper, we introduce two ML techniques into the geosteering decision support framework. Firstly, a complex earth model representation is generated using a Generative Adversarial Network (GAN). Secondly, a commercial extra-deep electromagnetic simulator is represented using a Forward Deep Neural Network (FDNN). The numerical experiments demonstrate that the combination of the GAN and the FDNN in an ensemble randomized maximum likelihood data assimilation scheme provides real-time estimates of complex geological uncertainty. This yields reduction of geological uncertainty ahead of the drill-bit from the measurements gathered behind and around the well bore.

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

Models that can predict the occurrence of events ahead of time with low false-alarm rates are critical to the acceptance of decision support systems in the medical community. This challenging task is typically treated as a simple binary classification, ignoring temporal dependencies between samples, whereas we propose to exploit this structure. We first introduce a common theoretical framework unifying dynamic survival analysis and early event prediction. Following an analysis of objectives from both fields, we propose Temporal Label Smoothing (TLS), a simpler, yet best-performing method that preserves prediction monotonicity over time. By focusing the objective on areas with a stronger predictive signal, TLS improves performance over all baselines on two large-scale benchmark tasks. Gains are particularly notable along clinically relevant measures, such as event recall at low false-alarm rates. TLS reduces the number of missed events by up to a factor of two over previously used approaches in early event prediction.

Automatic segmentation of the liver and hepatic lesions is an important step towards deriving quantitative biomarkers for accurate clinical diagnosis and computer-aided decision support systems. This paper presents a method to automatically segment liver and lesions in CT and MRI abdomen images using cascaded fully convolutional neural networks (CFCNs) enabling the segmentation of a large-scale medical trial or quantitative image analysis. We train and cascade two FCNs for a combined segmentation of the liver and its lesions. In the first step, we train a FCN to segment the liver as ROI input for a second FCN. The second FCN solely segments lesions within the predicted liver ROIs of step 1. CFCN models were trained on an abdominal CT dataset comprising 100 hepatic tumor volumes. Validations on further datasets show that CFCN-based semantic liver and lesion segmentation achieves Dice scores over 94% for liver with computation times below 100s per volume. We further experimentally demonstrate the robustness of the proposed method on an 38 MRI liver tumor volumes and the public 3DIRCAD dataset.

Large Language Model (LLM)-based agents are increasingly deployed in real-world applications such as "digital assistants, autonomous customer service, and decision-support systems", where their ability to "interact in multi-turn, tool-augmented environments" makes them indispensable. However, ensuring the safety of these agents remains a significant challenge due to the diverse and complex risks arising from dynamic user interactions, external tool usage, and the potential for unintended harmful behaviors. To address this critical issue, we propose AutoSafe, the first framework that systematically enhances agent safety through fully automated synthetic data generation. Concretely, 1) we introduce an open and extensible threat model, OTS, which formalizes how unsafe behaviors emerge from the interplay of user instructions, interaction contexts, and agent actions. This enables precise modeling of safety risks across diverse scenarios. 2) we develop a fully automated data generation pipeline that simulates unsafe user behaviors, applies self-reflective reasoning to generate safe responses, and constructs a large-scale, diverse, and high-quality safety training dataset-eliminating the need for hazardous real-world data collection. To evaluate the effectiveness of our framework, we design comprehensive experiments on both synthetic and real-world safety benchmarks. Results demonstrate that AutoSafe boosts safety scores by 45% on average and achieves a 28.91% improvement on real-world tasks, validating the generalization ability of our learned safety strategies. These results highlight the practical advancement and scalability of AutoSafe in building safer LLM-based agents for real-world deployment. We have released the project page at https://auto-safe.github.io/.

The demand for emergency department (ED) services is increasing across the globe, particularly during the current COVID-19 pandemic. Clinical triage and risk assessment have become increasingly challenging due to the shortage of medical resources and the strain on hospital infrastructure caused by the pandemic. As a result of the widespread use of electronic health records (EHRs), we now have access to a vast amount of clinical data, which allows us to develop predictive models and decision support systems to address these challenges. To date, however, there are no widely accepted benchmark ED triage prediction models based on large-scale public EHR data. An open-source benchmarking platform would streamline research workflows by eliminating cumbersome data preprocessing, and facilitate comparisons among different studies and methodologies. In this paper, based on the Medical Information Mart for Intensive Care IV Emergency Department (MIMIC-IV-ED) database, we developed a publicly available benchmark suite for ED triage predictive models and created a benchmark dataset that contains over 400,000 ED visits from 2011 to 2019. We introduced three ED-based outcomes (hospitalization, critical outcomes, and 72-hour ED reattendance) and implemented a variety of popular methodologies, ranging from machine learning methods to clinical scoring systems. We evaluated and compared the performance of these methods against benchmark tasks. Our codes are open-source, allowing anyone with MIMIC-IV-ED data access to perform the same steps in data processing, benchmark model building, and experiments. This study provides future researchers with insights, suggestions, and protocols for managing raw data and developing risk triaging tools for emergency care.

This thesis explores open-sourced machine learning (ML) model explanation tools to understand whether these tools can allow a layman to visualize, understand, and suggest intuitive remedies to unfairness in ML-based decision-support systems. Machine learning models trained on datasets biased against minority groups are increasingly used to guide life-altering social decisions, prompting the urgent need to study their logic for unfairness. Due to this problem's impact on vast populations of the general public, it is critical for the layperson -- not just subject matter experts in social justice or machine learning experts -- to understand the nature of unfairness within these algorithms and the potential trade-offs. Existing research on fairness in machine learning focuses mostly on the mathematical definitions and tools to understand and remedy unfair models, with some directly citing user-interactive tools as necessary for future work. This thesis presents FairLay-ML, a proof-of-concept GUI integrating some of the most promising tools to provide intuitive explanations for unfair logic in ML models by integrating existing research tools (e.g. Local Interpretable Model-Agnostic Explanations) with existing ML-focused GUI (e.g. Python Streamlit). We test FairLay-ML using models of various accuracy and fairness generated by an unfairness detector tool, Parfait-ML, and validate our results using Themis. Our study finds that the technology stack used for FairLay-ML makes it easy to install and provides real-time black-box explanations of pre-trained models to users. Furthermore, the explanations provided translate to actionable remedies.

As structured data are often insufficient, labels need to be extracted from free text in electronic health records when developing models for clinical information retrieval and decision support systems. One of the most important contextual properties in clinical text is negation, which indicates the absence of findings. We aimed to improve large scale extraction of labels by comparing three methods for negation detection in Dutch clinical notes. We used the Erasmus Medical Center Dutch Clinical Corpus to compare a rule-based method based on ContextD, a biLSTM model using MedCAT and (finetuned) RoBERTa-based models. We found that both the biLSTM and RoBERTa models consistently outperform the rule-based model in terms of F1 score, precision and recall. In addition, we systematically categorized the classification errors for each model, which can be used to further improve model performance in particular applications. Combining the three models naively was not beneficial in terms of performance. We conclude that the biLSTM and RoBERTa-based models in particular are highly accurate accurate in detecting clinical negations, but that ultimately all three approaches can be viable depending on the use case at hand.

Deep convolutional neural networks (CNNs) are the current state-of-the-art for digital analysis of histopathological images. The large size of whole-slide microscopy images (WSIs) requires advanced memory handling to read, display and process these images. There are several open-source platforms for working with WSIs, but few support deployment of CNN models. These applications use third-party solutions for inference, making them less user-friendly and unsuitable for high-performance image analysis. To make deployment of CNNs user-friendly and feasible on low-end machines, we have developed a new platform, FastPathology, using the FAST framework and C++. It minimizes memory usage for reading and processing WSIs, deployment of CNN models, and real-time interactive visualization of results. Runtime experiments were conducted on four different use cases, using different architectures, inference engines, hardware configurations and operating systems. Memory usage for reading, visualizing, zooming and panning a WSI were measured, using FastPathology and three existing platforms. FastPathology performed similarly in terms of memory to the other C++ based application, while using considerably less than the two Java-based platforms. The choice of neural network model, inference engine, hardware and processors influenced runtime considerably. Thus, FastPathology includes all steps needed for efficient visualization and processing of WSIs in a single application, including inference of CNNs with real-time display of the results. Source code, binary releases and test data can be found online on GitHub at https://github.com/SINTEFMedtek/FAST-Pathology/.

Throughout the course of my Ph.D., I have been designing the user experience (UX) of various machine learning (ML) systems. In this workshop, I share two projects as case studies in which people engage with ML in much more complicated and nuanced ways than the technical HCML work might assume. The first case study describes how cardiology teams in three hospitals used a clinical decision-support system that helps them decide whether and when to implant an artificial heart to a heart failure patient. I demonstrate that physicians cannot draw on their decision-making experience by seeing only patient data on paper. They are also confused by some fundamental premises upon which ML operates. For example, physicians asked: Are ML predictions made based on clinicians' best efforts? Is it ethical to make decisions based on previous patients' collective outcomes? In the second case study, my collaborators and I designed an intelligent text editor, with the goal of improving authors' writing experience with NLP (Natural Language Processing) technologies. We prototyped a number of generative functionalities where the system provides phrase-or-sentence-level writing suggestions upon user request. When writing with the prototype, however, authors shared that they need to "see where the sentence is going two paragraphs later" in order to decide whether the suggestion aligns with their writing; Some even considered adopting machine suggestions as plagiarism, therefore "is simply wrong". By sharing these unexpected and intriguing responses from these real-world ML users, I hope to start a discussion about such previously-unknown complexities and nuances of -- as the workshop proposal states -- "putting ML at the service of people in a way that is accessible, useful, and trustworthy to all".

Machine learning based decision-support tools in criminal justice systems are subjects of intense discussions and academic research. There are important open questions about the utility and fairness of such tools. Academic researchers often rely on a few small datasets that are not sufficient to empirically study various real-world aspects of these questions. In this paper, we contribute WCLD, a curated large dataset of 1.5 million criminal cases from circuit courts in the U.S. state of Wisconsin. We used reliable public data from 1970 to 2020 to curate attributes like prior criminal counts and recidivism outcomes. The dataset contains large number of samples from five racial groups, in addition to information like sex and age (at judgment and first offense). Other attributes in this dataset include neighborhood characteristics obtained from census data, detailed types of offense, charge severity, case decisions, sentence lengths, year of filing etc. We also provide pseudo-identifiers for judge, county and zipcode. The dataset will not only enable researchers to more rigorously study algorithmic fairness in the context of criminal justice, but also relate algorithmic challenges with various systemic issues. We also discuss in detail the process of constructing the dataset and provide a datasheet. The WCLD dataset is available at https://clezdata.github.io/wcld/.

Quantitative tools are increasingly appealing for decision support in healthcare, driven by the growing capabilities of advanced AI systems. However, understanding the predictive uncertainties surrounding a tool's output is crucial for decision-makers to ensure reliable and transparent decisions. In this paper, we present a case study on pulmonary nodule detection for lung cancer screening, enhancing an advanced detection model with an uncertainty quantification technique called conformal risk control (CRC). We demonstrate that prediction sets with conformal guarantees are attractive measures of predictive uncertainty in the safety-critical healthcare domain, allowing end-users to achieve arbitrary validity by trading off false positives and providing formal statistical guarantees on model performance. Among ground-truth nodules annotated by at least three radiologists, our model achieves a sensitivity that is competitive with that generally achieved by individual radiologists, with a slight increase in false positives. Furthermore, we illustrate the risks of using off-the-shelve prediction models when faced with ontological uncertainty, such as when radiologists disagree on what constitutes the ground truth on pulmonary nodules.

Large Language Models (LLMs) are increasingly deployed in mission-critical systems, facilitating tasks such as satellite operations, command-and-control, military decision support, and cyber defense. Many of these systems are accessed through application programming interfaces (APIs). When such APIs lack robust access controls, they can expose full or top-k logits, creating a significant and often overlooked attack surface. Prior art has mainly focused on reconstructing the output projection layer or distilling surface-level behaviors. However, regenerating a black-box model under tight query constraints remains underexplored. We address that gap by introducing a constrained replication pipeline that transforms partial logit leakage into a functional deployable substitute model clone. Our two-stage approach (i) reconstructs the output projection matrix by collecting top-k logits from under 10k black-box queries via singular value decomposition (SVD) over the logits, then (ii) distills the remaining architecture into compact student models with varying transformer depths, trained on an open source dataset. A 6-layer student recreates 97.6% of the 6-layer teacher model's hidden-state geometry, with only a 7.31% perplexity increase, and a 7.58 Negative Log-Likelihood (NLL). A 4-layer variant achieves 17.1% faster inference and 18.1% parameter reduction with comparable performance. The entire attack completes in under 24 graphics processing unit (GPU) hours and avoids triggering API rate-limit defenses. These results demonstrate how quickly a cost-limited adversary can clone an LLM, underscoring the urgent need for hardened inference APIs and secure on-premise defense deployments.

Large language models achieve high task performance yet often hallucinate or rely on outdated knowledge. Retrieval-augmented generation (RAG) addresses these gaps by coupling generation with external search. We analyse how hyperparameters influence speed and quality in RAG systems, covering Chroma and Faiss vector stores, chunking policies, cross-encoder re-ranking, and temperature, and we evaluate six metrics: faithfulness, answer correctness, answer relevancy, context precision, context recall, and answer similarity. Chroma processes queries 13% faster, whereas Faiss yields higher retrieval precision, revealing a clear speed-accuracy trade-off. Naive fixed-length chunking with small windows and minimal overlap outperforms semantic segmentation while remaining the quickest option. Re-ranking provides modest gains in retrieval quality yet increases runtime by roughly a factor of 5, so its usefulness depends on latency constraints. These results help practitioners balance computational cost and accuracy when tuning RAG systems for transparent, up-to-date responses. Finally, we re-evaluate the top configurations with a corrective RAG workflow and show that their advantages persist when the model can iteratively request additional evidence. We obtain a near-perfect context precision (99%), which demonstrates that RAG systems can achieve extremely high retrieval accuracy with the right combination of hyperparameters, with significant implications for applications where retrieval quality directly impacts downstream task performance, such as clinical decision support in healthcare.

The paper introduces D-CODE, a new framework blending Data Colony Optimization (DCO) algorithms inspired by biological colonies' collective behaviours with Dynamic Efficiency (DE) models for real-time adaptation. DCO utilizes metaheuristic strategies from ant colonies, bee swarms, and fungal networks to efficiently explore complex data landscapes, while DE enables continuous resource recalibration and process adjustments for optimal performance amidst changing conditions. Through a mixed-methods approach involving simulations and case studies, D-CODE outperforms traditional techniques, showing improvements of 3-4% in solution quality, 2-3 times faster convergence rates, and up to 25% higher computational efficiency. The integration of DCO's robust optimization and DE's dynamic responsiveness positions D-CODE as a transformative paradigm for intelligent systems design, with potential applications in operational efficiency, decision support, and computational intelligence, supported by empirical validation and promising outcomes.

In recent years, the rapid advancement of Large Language Models (LLMs) such as the Generative Pre-trained Transformer (GPT) has attracted increasing attention due to their potential in a variety of practical applications. The application of LLMs with Embodied Intelligence has emerged as a significant area of focus. Among the myriad applications of LLMs, navigation tasks are particularly noteworthy because they demand a deep understanding of the environment and quick, accurate decision-making. LLMs can augment embodied intelligence systems with sophisticated environmental perception and decision-making support, leveraging their robust language and image-processing capabilities. This article offers an exhaustive summary of the symbiosis between LLMs and embodied intelligence with a focus on navigation. It reviews state-of-the-art models, research methodologies, and assesses the advantages and disadvantages of existing embodied navigation models and datasets. Finally, the article elucidates the role of LLMs in embodied intelligence, based on current research, and forecasts future directions in the field. A comprehensive list of studies in this survey is available at https://github.com/Rongtao-Xu/Awesome-LLM-EN

Pain is a complex and pervasive condition that affects a significant portion of the population. Accurate and consistent assessment is essential for individuals suffering from pain, as well as for developing effective management strategies in a healthcare system. Automatic pain assessment systems enable continuous monitoring, support clinical decision-making, and help minimize patient distress while mitigating the risk of functional deterioration. Leveraging physiological signals offers objective and precise insights into a person's state, and their integration in a multimodal framework can further enhance system performance. This study has been submitted to the Second Multimodal Sensing Grand Challenge for Next-Gen Pain Assessment (AI4PAIN). The proposed approach introduces Tiny-BioMoE, a lightweight pretrained embedding model for biosignal analysis. Trained on 4.4 million biosignal image representations and consisting of only 7.3 million parameters, it serves as an effective tool for extracting high-quality embeddings for downstream tasks. Extensive experiments involving electrodermal activity, blood volume pulse, respiratory signals, peripheral oxygen saturation, and their combinations highlight the model's effectiveness across diverse modalities in automatic pain recognition tasks. The model's architecture (code) and weights are available at https://github.com/GkikasStefanos/Tiny-BioMoE.

A computational ethics framework is essential for AI and autonomous systems operating in complex, real-world environments. Existing approaches often lack the adaptability needed to integrate ethical principles into dynamic and ambiguous contexts, limiting their effectiveness across diverse scenarios. To address these challenges, we outline the necessary ingredients for building a holistic, meta-level framework that combines intermediate representations, probabilistic reasoning, and knowledge representation. The specifications therein emphasize scalability, supporting ethical reasoning at both individual decision-making levels and within the collective dynamics of multi-agent systems. By integrating theoretical principles with contextual factors, it facilitates structured and context-aware decision-making, ensuring alignment with overarching ethical standards. We further explore proposed theorems outlining how ethical reasoners should operate, offering a foundation for practical implementation. These constructs aim to support the development of robust and ethically reliable AI systems capable of navigating the complexities of real-world moral decision-making scenarios.

As humans delegate more tasks and decisions to artificial intelligence (AI), we risk losing control of our individual and collective futures. Relatively simple algorithmic systems already steer human decision-making, such as social media feed algorithms that lead people to unintentionally and absent-mindedly scroll through engagement-optimized content. In this paper, we develop the idea of human agency by integrating philosophical and scientific theories of agency with AI-assisted evaluation methods: using large language models (LLMs) to simulate and validate user queries and to evaluate AI responses. We develop HumanAgencyBench (HAB), a scalable and adaptive benchmark with six dimensions of human agency based on typical AI use cases. HAB measures the tendency of an AI assistant or agent to Ask Clarifying Questions, Avoid Value Manipulation, Correct Misinformation, Defer Important Decisions, Encourage Learning, and Maintain Social Boundaries. We find low-to-moderate agency support in contemporary LLM-based assistants and substantial variation across system developers and dimensions. For example, while Anthropic LLMs most support human agency overall, they are the least supportive LLMs in terms of Avoid Value Manipulation. Agency support does not appear to consistently result from increasing LLM capabilities or instruction-following behavior (e.g., RLHF), and we encourage a shift towards more robust safety and alignment targets.

Automatically repairing software issues remains a fundamental challenge at the intersection of software engineering and AI. Although recent advancements in Large Language Models (LLMs) have demonstrated potential for repository-level repair tasks, current methodologies exhibit two notable limitations: (1) they often address issues in isolation, neglecting to incorporate insights from previously resolved issues, and (2) they rely on static and rigid prompting strategies, which constrain their ability to generalize across diverse and evolving issue scenarios. Inspired by the dual memory systems of human cognition, where episodic and semantic memories work synergistically to support human reasoning and decision-making, we propose ExpeRepair, a novel LLM-based approach that continuously learns from historical repair experiences through dual-channel knowledge accumulation. ExpeRepair organizes historical repair experiences into two complementary memories: an episodic memory that stores concrete repair demonstrations, and a semantic memory that encodes abstract reflective insights. At inference time, ExpeRepair activates both memory systems by retrieving relevant demonstrations from episodic memory and recalling high-level repair insights from semantic memory. It further enhances adaptability through dynamic prompt composition, synergistically integrating both memory types to replace static prompts with context-aware, experience-driven prompts. Experiments on the SWE-bench Lite benchmark demonstrate that ExpeRepair achieves a pass@1 score of 49.3% with Claude 3.7 Sonnet, outperforming all state-of-the-art open-source methods.

The emergence of Large Language Models (LLMs) has significantly advanced solutions across various domains, from political science to software development. However, these models are constrained by their training data, which is static and limited to information available up to a specific date. Additionally, their generalized nature often necessitates fine-tuning -- whether for classification or instructional purposes -- to effectively perform specific downstream tasks. AI agents, leveraging LLMs as their core, mitigate some of these limitations by accessing external tools and real-time data, enabling applications such as live weather reporting and data analysis. In industrial settings, AI agents are transforming operations by enhancing decision-making, predictive maintenance, and process optimization. For example, in manufacturing, AI agents enable near-autonomous systems that boost productivity and support real-time decision-making. Despite these advancements, AI agents remain vulnerable to security threats, including prompt injection attacks, which pose significant risks to their integrity and reliability. To address these challenges, this paper proposes a framework for integrating Role-Based Access Control (RBAC) into AI agents, providing a robust security guardrail. This framework aims to support the effective and scalable deployment of AI agents, with a focus on on-premises implementations.

Like other fields of Traditional Medicines, Unani Medicines have been found as an effective medical practice for ages. It is still widely used in the subcontinent, particularly in Pakistan and India. However, Unani Medicines Practitioners are lacking modern IT applications in their everyday clinical practices. An Online Clinical Decision Support System may address this challenge to assist apprentice Unani Medicines practitioners in their diagnostic processes. The proposed system provides a web-based interface to enter the patient's symptoms, which are then automatically analyzed by our system to generate a list of probable diseases. The system allows practitioners to choose the most likely disease and inform patients about the associated treatment options remotely. The system consists of three modules: an Online Clinical Decision Support System, an Artificial Intelligence Inference Engine, and a comprehensive Unani Medicines Database. The system employs advanced AI techniques such as Decision Trees, Deep Learning, and Natural Language Processing. For system development, the project team used a technology stack that includes React, FastAPI, and MySQL. Data and functionality of the application is exposed using APIs for integration and extension with similar domain applications. The novelty of the project is that it addresses the challenge of diagnosing diseases accurately and efficiently in the context of Unani Medicines principles. By leveraging the power of technology, the proposed Clinical Decision Support System has the potential to ease access to healthcare services and information, reduce cost, boost practitioner and patient satisfaction, improve speed and accuracy of the diagnostic process, and provide effective treatments remotely. The application will be useful for Unani Medicines Practitioners, Patients, Government Drug Regulators, Software Developers, and Medical Researchers.

Clinical evidence, derived from rigorous research and data analysis, provides healthcare professionals with reliable scientific foundations for informed decision-making. Integrating clinical evidence into real-time practice is challenging due to the enormous workload, complex professional processes, and time constraints. This highlights the need for tools that automate evidence synthesis to support more efficient and accurate decision making in clinical settings. This study introduces Quicker, an evidence-based clinical decision support system powered by large language models (LLMs), designed to automate evidence synthesis and generate clinical recommendations modeled after standard clinical guideline development processes. Quicker implements a fully automated chain that covers all phases, from questions to clinical recommendations, and further enables customized decision-making through integrated tools and interactive user interfaces. To evaluate Quicker's capabilities, we developed the Q2CRBench-3 benchmark dataset, based on clinical guideline development records for three different diseases. Experimental results highlighted Quicker's strong performance, with fine-grained question decomposition tailored to user preferences, retrieval sensitivities comparable to human experts, and literature screening performance approaching comprehensive inclusion of relevant studies. In addition, Quicker-assisted evidence assessment effectively supported human reviewers, while Quicker's recommendations were more comprehensive and logically coherent than those of clinicians. In system-level testing, collaboration between a single reviewer and Quicker reduced the time required for recommendation development to 20-40 minutes. In general, our findings affirm the potential of Quicker to help physicians make quicker and more reliable evidence-based clinical decisions.

Skilled employees are the most important pillars of an organization. Despite this, most organizations face high attrition and turnover rates. While several machine learning models have been developed to analyze attrition and its causal factors, the interpretations of those models remain opaque. In this paper, we propose the HR-DSS approach, which stands for Human Resource (HR) Decision Support System, and uses explainable AI for employee attrition problems. The system is designed to assist HR departments in interpreting the predictions provided by machine learning models. In our experiments, we employ eight machine learning models to provide predictions. We further process the results achieved by the best-performing model by the SHAP explainability process and use the SHAP values to generate natural language explanations which can be valuable for HR. Furthermore, using "What-if-analysis", we aim to observe plausible causes for attrition of an individual employee. The results show that by adjusting the specific dominant features of each individual, employee attrition can turn into employee retention through informative business decisions.

Nitrogen (N) management is critical to sustain soil fertility and crop production while minimizing the negative environmental impact, but is challenging to optimize. This paper proposes an intelligent N management system using deep reinforcement learning (RL) and crop simulations with Decision Support System for Agrotechnology Transfer (DSSAT). We first formulate the N management problem as an RL problem. We then train management policies with deep Q-network and soft actor-critic algorithms, and the Gym-DSSAT interface that allows for daily interactions between the simulated crop environment and RL agents. According to the experiments on the maize crop in both Iowa and Florida in the US, our RL-trained policies outperform previous empirical methods by achieving higher or similar yield while using less fertilizers

This study critically distinguishes between AI Agents and Agentic AI, offering a structured conceptual taxonomy, application mapping, and challenge analysis to clarify their divergent design philosophies and capabilities. We begin by outlining the search strategy and foundational definitions, characterizing AI Agents as modular systems driven by Large Language Models (LLMs) and Large Image Models (LIMs) for narrow, task-specific automation. Generative AI is positioned as a precursor, with AI Agents advancing through tool integration, prompt engineering, and reasoning enhancements. In contrast, Agentic AI systems represent a paradigmatic shift marked by multi-agent collaboration, dynamic task decomposition, persistent memory, and orchestrated autonomy. Through a sequential evaluation of architectural evolution, operational mechanisms, interaction styles, and autonomy levels, we present a comparative analysis across both paradigms. Application domains such as customer support, scheduling, and data summarization are contrasted with Agentic AI deployments in research automation, robotic coordination, and medical decision support. We further examine unique challenges in each paradigm including hallucination, brittleness, emergent behavior, and coordination failure and propose targeted solutions such as ReAct loops, RAG, orchestration layers, and causal modeling. This work aims to provide a definitive roadmap for developing robust, scalable, and explainable AI agent and Agentic AI-driven systems. >AI Agents, Agent-driven, Vision-Language-Models, Agentic AI Decision Support System, Agentic-AI Applications

We address a challenging and practical task of labeling questions in speech in real time during telephone calls to emergency medical services in English, which embeds within a broader decision support system for emergency call-takers. We propose a novel multimodal approach to real-time sequence labeling in speech. Our model treats speech and its own textual representation as two separate modalities or views, as it jointly learns from streamed audio and its noisy transcription into text via automatic speech recognition. Our results show significant gains of jointly learning from the two modalities when compared to text or audio only, under adverse noise and limited volume of training data. The results generalize to medical symptoms detection where we observe a similar pattern of improvements with multimodal learning.

Finding relevant literature underpins the practice of evidence-based medicine. From 2014 to 2016, TREC conducted a clinical decision support track, wherein participants were tasked with finding articles relevant to clinical questions posed by physicians. In total, 87 teams have participated over the past three years, generating 395 runs. During this period, each team has trialled a variety of methods. While there was significant overlap in the methods employed by different teams, the results were varied. Due to the diversity of the platforms used, the results arising from the different techniques are not directly comparable, reducing the ability to build on previous work. By using a stable platform, we have been able to compare different document and query processing techniques, allowing us to experiment with different search parameters. We have used our system to reproduce leading teams runs, and compare the results obtained. By benchmarking our indexing and search techniques, we can statistically test a variety of hypotheses, paving the way for further research.

We present the Process Engineering Operations Assistant (PEOA), an AI-driven framework designed to solve complex problems in the chemical and process industries. The framework employs a modular architecture orchestrated by a meta-agent, which serves as the central coordinator, managing an action generator and instruction-tuned small-scale language models (expert models). The action generator decomposes complex problems into sub-tasks and identifies suitable expert models to execute each, delivering precise solutions for multi-step problem-solving. Key techniques include advanced knowledge modeling using property graphs for improved information retrieval, facilitating more accurate and contextually relevant solutions. Additionally, the framework utilizes a teacher-student transfer-learning approach with GPT-4 (Omni) to fine-tune the action generator and expert models for domain adaptation, alongside an iterative problem-solving mechanism with sophisticated error handling. Custom datasets were developed to evaluate the framework against leading proprietary language models on various engineering tasks. The results demonstrate the framework effectiveness in automating calculations, accelerating prototyping, and providing AI-augmented decision support for industrial processes, marking a significant advancement in process engineering capabilities.

Ensuring the safety and reliability of large language models (LLMs) in clinical practice is critical to prevent patient harm and promote trustworthy healthcare applications of AI. However, LLMs are advancing so rapidly that static safety benchmarks often become obsolete upon publication, yielding only an incomplete and sometimes misleading picture of model trustworthiness. We demonstrate that a Dynamic, Automatic, and Systematic (DAS) red-teaming framework that continuously stress-tests LLMs can reveal significant weaknesses of current LLMs across four safety-critical domains: robustness, privacy, bias/fairness, and hallucination. A suite of adversarial agents is applied to autonomously mutate test cases, identify/evolve unsafe-triggering strategies, and evaluate responses, uncovering vulnerabilities in real time without human intervention. Applying DAS to 15 proprietary and open-source LLMs revealed a stark contrast between static benchmark performance and vulnerability under adversarial pressure. Despite a median MedQA accuracy exceeding 80\%, 94\% of previously correct answers failed our dynamic robustness tests. We observed similarly high failure rates across other domains: privacy leaks were elicited in 86\% of scenarios, cognitive-bias priming altered clinical recommendations in 81\% of fairness tests, and we identified hallucination rates exceeding 66\% in widely used models. Such profound residual risks are incompatible with routine clinical practice. By converting red-teaming from a static checklist into a dynamic stress-test audit, DAS red-teaming offers the surveillance that hospitals/regulators/technology vendors require as LLMs become embedded in patient chatbots, decision-support dashboards, and broader healthcare workflows. Our framework delivers an evolvable, scalable, and reliable safeguard for the next generation of medical AI.

Uniform random exploration in decision-making systems supports off-policy learning via supervision but incurs high regret, making it impractical for many applications. Conversely, non-uniform exploration offers better immediate performance but lacks support for off-policy learning. Recent research suggests that regression oracles can bridge this gap by combining non-uniform exploration with supervised learning. In this paper, we analyze these approaches within a real-world industrial context at Adyen, a large global payments processor characterized by batch logged delayed feedback, short-term memory, and dynamic action spaces under the Empirical Risk Minimization (ERM) framework. Our analysis reveals that while regression oracles significantly improve performance, they introduce challenges due to rigid algorithmic assumptions. Specifically, we observe that as a policy improves, subsequent generations may perform worse due to shifts in the reward distribution and increased class imbalance in the training data. This degradation occurs de spite improvements in other aspects of the training data, leading to decreased performance in successive policy iterations. We further explore the long-term impact of regression oracles, identifying a potential "oscillation effect." This effect arises when regression oracles influence probability estimates and the realizability of subsequent policy models, leading to fluctuations in performance across iterations. Our findings highlight the need for more adaptable algorithms that can leverage the benefits of regression oracles without introducing instability in policy performance over time.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

Digital healthcare infrastructure is crucial for global medical service delivery. Egypt faces EHR adoption barriers: only 314 hospitals had such systems as of Oct 2024. This limits data management and decision-making. This project introduces an EHR system for Egypt's Universal Health Insurance and healthcare ecosystem. It simplifies data management by centralizing medical histories with a scalable micro-services architecture and polyglot persistence for real-time access and provider communication. Clinical workflows are enhanced via patient examination and history tracking. The system uses the Llama3-OpenBioLLM-70B model to generate summaries of medical histories, provide chatbot features, and generate AI-based medical reports, enabling efficient searches during consultations. A Vision Transformer (ViT) aids in pneumonia classification. Evaluations show the AI excels in capturing details (high recall) but needs improvement in concise narratives. With optimization (retrieval-augmented generation, local data fine-tuning, interoperability protocols), this AI-driven EHR could enhance diagnostic support, decision-making, and healthcare delivery in Egypt.

The damage and the impact of natural disasters are becoming more destructive with the increase of urbanization. Today's metropolitan cities are not sufficiently prepared for the pre and post-disaster situations. Digital Twin technology can provide a solution. A virtual copy of the physical city could be created by collecting data from sensors of the Internet of Things (IoT) devices and stored on the cloud infrastructure. This virtual copy is kept current and up to date with the continuous flow of the data coming from the sensors. We propose a disaster management system utilizing machine learning called DT-DMS is used to support decision-making mechanisms. This study aims to show how to educate and prepare emergency center staff by simulating potential disaster situations on the virtual copy. The event of a disaster will be simulated allowing emergency center staff to make decisions and depicting the potential outcomes of these decisions. A rescue operation after an earthquake is simulated. Test results are promising and the simulation scope is planned to be extended.

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

This article conducts a literature review of current and future challenges in the use of artificial intelligence (AI) in cyber physical systems. The literature review is focused on identifying a conceptual framework for increasing resilience with AI through automation supporting both, a technical and human level. The methodology applied resembled a literature review and taxonomic analysis of complex internet of things (IoT) interconnected and coupled cyber physical systems. There is an increased attention on propositions on models, infrastructures and frameworks of IoT in both academic and technical papers. These reports and publications frequently represent a juxtaposition of other related systems and technologies (e.g. Industrial Internet of Things, Cyber Physical Systems, Industry 4.0 etc.). We review academic and industry papers published between 2010 and 2020. The results determine a new hierarchical cascading conceptual framework for analysing the evolution of AI decision-making in cyber physical systems. We argue that such evolution is inevitable and autonomous because of the increased integration of connected devices (IoT) in cyber physical systems. To support this argument, taxonomic methodology is adapted and applied for transparency and justifications of concepts selection decisions through building summary maps that are applied for designing the hierarchical cascading conceptual framework.

Building agents, systems that perceive and act upon their environment with a degree of autonomy, has long been a focus of AI research. This pursuit has recently become vastly more practical with the emergence of large language models (LLMs) capable of using natural language to integrate information, follow instructions, and perform forms of "reasoning" and planning across a wide range of tasks. With its multimodal data streams and orchestrated workflows spanning multiple systems, radiology is uniquely suited to benefit from agents that can adapt to context and automate repetitive yet complex tasks. In radiology, LLMs and their multimodal variants have already demonstrated promising performance for individual tasks such as information extraction and report summarization. However, using LLMs in isolation underutilizes their potential to support complex, multi-step workflows where decisions depend on evolving context from multiple information sources. Equipping LLMs with external tools and feedback mechanisms enables them to drive systems that exhibit a spectrum of autonomy, ranging from semi-automated workflows to more adaptive agents capable of managing complex processes. This review examines the design of such LLM-driven agentic systems, highlights key applications, discusses evaluation methods for planning and tool use, and outlines challenges such as error cascades, tool-use efficiency, and health IT integration.

This paper introduces GUI-Owl, a foundational GUI agent model that achieves state-of-the-art performance among open-source end-to-end models on ten GUI benchmarks across desktop and mobile environments, covering grounding, question answering, planning, decision-making, and procedural knowledge. GUI-Owl-7B achieves 66.4 on AndroidWorld and 29.4 on OSWorld. Building on this, we propose Mobile-Agent-v3, a general-purpose GUI agent framework that further improves performance to 73.3 on AndroidWorld and 37.7 on OSWorld, setting a new state-of-the-art for open-source GUI agent frameworks. GUI-Owl incorporates three key innovations: (1) Large-scale Environment Infrastructure: a cloud-based virtual environment spanning Android, Ubuntu, macOS, and Windows, enabling our Self-Evolving GUI Trajectory Production framework. This generates high-quality interaction data via automated query generation and correctness validation, leveraging GUI-Owl to refine trajectories iteratively, forming a self-improving loop. It supports diverse data pipelines and reduces manual annotation. (2) Diverse Foundational Agent Capabilities: by integrating UI grounding, planning, action semantics, and reasoning patterns, GUI-Owl supports end-to-end decision-making and can act as a modular component in multi-agent systems. (3) Scalable Environment RL: we develop a scalable reinforcement learning framework with fully asynchronous training for real-world alignment. We also introduce Trajectory-aware Relative Policy Optimization (TRPO) for online RL, achieving 34.9 on OSWorld. GUI-Owl and Mobile-Agent-v3 are open-sourced at https://github.com/X-PLUG/MobileAgent.

Large language models (LLMs) present intriguing opportunities to enhance user interaction with traditional algorithms and tools in real-world applications. An advanced planning system (APS) is a sophisticated software that leverages optimization to help operations planners create, interpret, and modify an operational plan. While highly beneficial, many customers are priced out of using an APS due to the ongoing costs of consultants responsible for customization and maintenance. To address the need for a more accessible APS expressed by supply chain planners, we present SmartAPS, a conversational system built on a tool-augmented LLM. Our system provides operations planners with an intuitive natural language chat interface, allowing them to query information, perform counterfactual reasoning, receive recommendations, and execute scenario analysis to better manage their operation. A short video demonstrating the system has been released: https://youtu.be/KtIrJjlDbyw

Large language models (LLMs) are increasingly used across society, including in domains like business, engineering, and medicine. These fields often grapple with decision-making under uncertainty, a critical yet challenging task. In this paper, we show that directly prompting LLMs on these types of decision-making problems yields poor results, especially as the problem complexity increases. To overcome this limitation, we propose DeLLMa (Decision-making Large Language Model assistant), a framework designed to enhance decision-making accuracy in uncertain environments. DeLLMa involves a multi-step scaffolding procedure, drawing upon principles from decision theory and utility theory, to provide an optimal and human-auditable decision-making process. We validate our framework on decision-making environments involving real agriculture and finance data. Our results show that DeLLMa can significantly improve LLM decision-making performance, achieving up to a 40% increase in accuracy over competing methods.

In the field of business data analysis, the ability to extract actionable insights from vast and varied datasets is essential for informed decision-making and maintaining a competitive edge. Traditional rule-based systems, while reliable, often fall short when faced with the complexity and dynamism of modern business data. Conversely, Artificial Intelligence (AI) models, particularly Large Language Models (LLMs), offer significant potential in pattern recognition and predictive analytics but can lack the precision necessary for specific business applications. This paper explores the efficacy of hybrid approaches that integrate the robustness of rule-based systems with the adaptive power of LLMs in generating actionable business insights.

Numerous real-world decision-making problems can be formulated and solved using Mixed-Integer Linear Programming (MILP) models. However, the transformation of these problems into MILP models heavily relies on expertise in operations research and mathematical optimization, which restricts non-experts' accessibility to MILP. To address this challenge, we propose a framework for automatically formulating MILP models from unstructured natural language descriptions of decision problems, which integrates Large Language Models (LLMs) and mathematical modeling techniques. This framework consists of three phases: i) identification of decision variables, ii) classification of objective and constraints, and iii) finally, generation of MILP models. In this study, we present a constraint classification scheme and a set of constraint templates that can guide the LLMs in synthesizing a complete MILP model. After fine-tuning LLMs, our approach can identify and synthesize logic constraints in addition to classic demand and resource constraints. The logic constraints have not been studied in existing work. To evaluate the performance of the proposed framework, we extend the NL4Opt dataset with more problem descriptions and constraint types, and with the new dataset, we compare our framework with one-step model generation methods offered by LLMs. The experimental results reveal that with respect to the accuracies of generating the correct model, objective, and constraints, our method which integrates constraint classification and templates with LLMs significantly outperforms the others. The prototype system that we developed has a great potential to capture more constraints for more complex MILPs. It opens up opportunities for developing training tools for operations research practitioners and has the potential to be a powerful tool for automatic decision problem modeling and solving in practice.

Data-driven optimization uses contextual information and machine learning algorithms to find solutions to decision problems with uncertain parameters. While a vast body of work is dedicated to interpreting machine learning models in the classification setting, explaining decision pipelines involving learning algorithms remains unaddressed. This lack of interpretability can block the adoption of data-driven solutions as practitioners may not understand or trust the recommended decisions. We bridge this gap by introducing a counterfactual explanation methodology tailored to explain solutions to data-driven problems. We introduce two classes of explanations and develop methods to find nearest explanations of random forest and nearest-neighbor predictors. We demonstrate our approach by explaining key problems in operations management such as inventory management and routing.

Recommender systems are software applications that help users to find items of interest in situations of information overload. Current research often assumes a one-shot interaction paradigm, where the users' preferences are estimated based on past observed behavior and where the presentation of a ranked list of suggestions is the main, one-directional form of user interaction. Conversational recommender systems (CRS) take a different approach and support a richer set of interactions. These interactions can, for example, help to improve the preference elicitation process or allow the user to ask questions about the recommendations and to give feedback. The interest in CRS has significantly increased in the past few years. This development is mainly due to the significant progress in the area of natural language processing, the emergence of new voice-controlled home assistants, and the increased use of chatbot technology. With this paper, we provide a detailed survey of existing approaches to conversational recommendation. We categorize these approaches in various dimensions, e.g., in terms of the supported user intents or the knowledge they use in the background. Moreover, we discuss technological approaches, review how CRS are evaluated, and finally identify a number of gaps that deserve more research in the future.

Machine learning models always make a prediction, even when it is likely to be inaccurate. This behavior should be avoided in many decision support applications, where mistakes can have severe consequences. Albeit already studied in 1970, machine learning with rejection recently gained interest. This machine learning subfield enables machine learning models to abstain from making a prediction when likely to make a mistake. This survey aims to provide an overview on machine learning with rejection. We introduce the conditions leading to two types of rejection, ambiguity and novelty rejection, which we carefully formalize. Moreover, we review and categorize strategies to evaluate a model's predictive and rejective quality. Additionally, we define the existing architectures for models with rejection and describe the standard techniques for learning such models. Finally, we provide examples of relevant application domains and show how machine learning with rejection relates to other machine learning research areas.

Despite advances in AI's performance and interpretability, AI advisors can undermine experts' decisions and increase the time and effort experts must invest to make decisions. Consequently, AI systems deployed in high-stakes settings often fail to consistently add value across contexts and can even diminish the value that experts alone provide. Beyond harm in specific domains, such outcomes impede progress in research and practice, underscoring the need to understand when and why different AI advisors add or diminish value. To bridge this gap, we stress the importance of assessing the value AI advice brings to real-world contexts when designing and evaluating AI advisors. Building on this perspective, we characterize key pillars -- pathways through which AI advice impacts value -- and develop a framework that incorporates these pillars to create reliable, personalized, and value-adding advisors. Our results highlight the need for system-level, value-driven development of AI advisors that advise selectively, are tailored to experts' unique behaviors, and are optimized for context-specific trade-offs between decision improvements and advising costs. They also reveal how the lack of inclusion of these pillars in the design of AI advising systems may be contributing to the failures observed in practical applications.

Machine learning plays a role in many deployed decision systems, often in ways that are difficult or impossible to understand by human stakeholders. Explaining, in a human-understandable way, the relationship between the input and output of machine learning models is essential to the development of trustworthy machine learning based systems. A burgeoning body of research seeks to define the goals and methods of explainability in machine learning. In this paper, we seek to review and categorize research on counterfactual explanations, a specific class of explanation that provides a link between what could have happened had input to a model been changed in a particular way. Modern approaches to counterfactual explainability in machine learning draw connections to the established legal doctrine in many countries, making them appealing to fielded systems in high-impact areas such as finance and healthcare. Thus, we design a rubric with desirable properties of counterfactual explanation algorithms and comprehensively evaluate all currently proposed algorithms against that rubric. Our rubric provides easy comparison and comprehension of the advantages and disadvantages of different approaches and serves as an introduction to major research themes in this field. We also identify gaps and discuss promising research directions in the space of counterfactual explainability.

Applying DevOps practices to machine learning system is termed as MLOps and machine learning systems evolve on new data unlike traditional systems on requirements. The objective of MLOps is to establish a connection between different open-source tools to construct a pipeline that can automatically perform steps to construct a dataset, train the machine learning model and deploy the model to the production as well as store different versions of model and dataset. Benefits of MLOps is to make sure the fast delivery of the new trained models to the production to have accurate results. Furthermore, MLOps practice impacts the overall quality of the software products and is completely dependent on open-source tools and selection of relevant open-source tools is considered as challenged while a generalized method to select an appropriate open-source tools is desirable. In this paper, we present a framework for recommendation system that processes the contextual information (e.g., nature of data, type of the data) of the machine learning project and recommends a relevant toolchain (tech-stack) for the operationalization of machine learning systems. To check the applicability of the proposed framework, four different approaches i.e., rule-based, random forest, decision trees and k-nearest neighbors were investigated where precision, recall and f-score is measured, the random forest out classed other approaches with highest f-score value of 0.66.

The current literature on AI-advised decision making -- involving explainable AI systems advising human decision makers -- presents a series of inconclusive and confounding results. To synthesize these findings, we propose a simple theory that elucidates the frequent failure of AI explanations to engender appropriate reliance and complementary decision making performance. We argue explanations are only useful to the extent that they allow a human decision maker to verify the correctness of an AI's prediction, in contrast to other desiderata, e.g., interpretability or spelling out the AI's reasoning process. Prior studies find in many decision making contexts AI explanations do not facilitate such verification. Moreover, most tasks fundamentally do not allow easy verification, regardless of explanation method, limiting the potential benefit of any type of explanation. We also compare the objective of complementary performance with that of appropriate reliance, decomposing the latter into the notions of outcome-graded and strategy-graded reliance.

LLMs have immense potential for generating plans, transforming an initial world state into a desired goal state. A large body of research has explored the use of LLMs for various planning tasks, from web navigation to travel planning and database querying. However, many of these systems are tailored to specific problems, making it challenging to compare them or determine the best approach for new tasks. There is also a lack of clear and consistent evaluation criteria. Our survey aims to offer a comprehensive overview of current LLM planners to fill this gap. It builds on foundational work by Kartam and Wilkins (1990) and examines six key performance criteria: completeness, executability, optimality, representation, generalization, and efficiency. For each, we provide a thorough analysis of representative works and highlight their strengths and weaknesses. Our paper also identifies crucial future directions, making it a valuable resource for both practitioners and newcomers interested in leveraging LLM planning to support agentic workflows.

In this paper, we conduct a study to utilize LLMs as a solution for decision making that requires complex data analysis. We define Decision QA as the task of answering the best decision, d_{best}, for a decision-making question Q, business rules R and a database D. Since there is no benchmark that can examine Decision QA, we propose Decision QA benchmark, DQA. It has two scenarios, Locating and Building, constructed from two video games (Europa Universalis IV and Victoria 3) that have almost the same goal as Decision QA. To address Decision QA effectively, we also propose a new RAG technique called the iterative plan-then-retrieval augmented generation (PlanRAG). Our PlanRAG-based LM generates the plan for decision making as the first step, and the retriever generates the queries for data analysis as the second step. The proposed method outperforms the state-of-the-art iterative RAG method by 15.8% in the Locating scenario and by 7.4% in the Building scenario, respectively. We release our code and benchmark at https://github.com/myeon9h/PlanRAG.