Medical
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HCOE: Hyperbolic Clinical Ontology Embeddings from Biomedical Language Models
2026-09-25 03:39:25Yixuan Li, Weihao Li, Ziyang SongAbstract
Biomedical language models (LMs) encode textual semantics but do not explicitly preserve medical code hierarchies. We present Hyperbolic Clinical Ontology Embeddings (HCOE) for hierarchy-aware clinical concept representation. HCOE maps frozen BioBERT embeddings into a Poincare ball, combining parent-side and child-side ontology-guided contrastive learning with coarse-to-fine ontology-path aggregation. It uses International Classification of Diseases (ICD) codes organized by Clinical Classifications Software (CCS) and Anatomical Therapeutic Chemical (ATC) medication hierarchies. Evaluations show that HCOE performs best on ICD/ATC clinical relation prediction and CCS-to-PheCode hierarchy transfer. On the MIMIC-IV dataset, HCOE also achieves the best performance on mortality prediction, readmission prediction, medication recommendation, and rare drug prediction.
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https://arxiv.org/abs/2609.30763
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Anatomy-Aware Dexterity-Driven Design Optimization of Surgical Continuum Robots
2026-09-25 03:18:39Tony Qin, Peter Connor, Khoa Dang, Carter Hatch, Caleb Rucker, Robert J. Webster III, Ron AlterovitzAbstract
Performing complex medical procedures with continuum robots requires careful selection of their geometric design parameters. The robot should have high dexterity in the specific anatomical environment of its procedure. This work presents a design optimization method that considers both dexterity and anatomy. We introduce the Reachable Volumetric Dexterous Solid Angle (RVDSA) metric as our objective, which measures the ability of a robot's end effector to reach the points in a goal volume from different directions via collision-free paths from a start configuration. We present a computationally efficient motion planner to compute this objective function for a given robotic design, and we use an asymptotically optimal simulated annealing optimizer to compute an optimized design. We applied our new method to optimize the design of a bimanual dexterous sheaths robot for performing procedures on cancerous polyps in colon anatomies, achieving a 78% higher RVDSA on average than optimizing for 3D voxel coverage alone.
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https://arxiv.org/abs/2609.30745
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CRC-Router: Risk-Constrained Routing for Medical Agentic AI Systems
2026-09-25 02:42:15Xueyang Li, Mingze Jiang, Gelei Xu, Jun Xia, Ching-Hao Chiu, Mengzhao Jia, Danny Z. Chen, Yiyu ShiAbstract
Agentic AI systems are increasingly being explored in medical imaging to improve throughput and reduce clinician workload; however, safe deployment remains challenging because autonomous errors may propagate into downstream clinical decisions. A central requirement is therefore not only strong predictive performance, but also a reliable routing mechanism that determines when the system should proceed autonomously and when a case should be escalated for further review. To address this gap, we propose CRC-Router, a risk-constrained, uncertainty-aware routing module that is applicable to both conventional medical prediction models and agentic medical AI systems. CRC-Router combines multiple complementary uncertainty signals with the predictive score to construct a per-finding routing feature vector, maps this vector to an estimated wrong-accept risk using a lightweight per-finding risk model, and then applies Conformal Risk Control (CRC) to calibrate acceptance thresholds under a user-specified risk target. Instantiated on chest X-ray multi-finding triage using the NIH ChestX-ray14 dataset, CRC-Router achieves the strongest empirical risk--coverage trade-off among the evaluated baselines, both as a standalone routing layer and as a plug-in module integrated with the state-of-the-art MedRAX agent. These results demonstrate both the effectiveness of CRC-Router in selective medical automation and its modular, model-agnostic compatibility with existing predictive and agentic medical pipelines. Code is publicly available at this https URL
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https://arxiv.org/abs/2609.30714
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Combining General and Domain-Specific Pretext Tasks for Brain MR Image Segmentation
2026-09-25 02:36:20Tasneem Nasser, Susanne Schmid, Roberto Souza, Naser El-SheimyAbstract
A key challenge in medical image analysis is the scarcity of large annotated datasets for specific populations and diseases. As deep learning models rely heavily on labeled data, effective transfer learning strategies are needed to reduce the dependence on manual annotations. Self-supervised learning has emerged as a promising approach for developing foundation models by enabling the learning of transferable feature representations from large-scale unlabeled medical imaging datasets. In this study, we investigate voxel-level brain age prediction as a domain-specific self-supervised pretext task and compare it with image inpainting, a widely used non-domain-specific alternative. We further propose a multitask self-supervised pretraining framework that jointly optimizes both objectives to learn complementary neuroimaging representations. The pretrained models are evaluated on three downstream magnetic resonance image segmentation tasks: multiple sclerosis lesion segmentation, ischemic stroke lesion segmentation, and cortical brain structure segmentation. Overall, the proposed multitask pretraining framework consistently outperformed the single-task pretrained models and training from scratch across most experimental settings, demonstrating the benefit of combining domain-specific and general self-supervised learning pretext tasks for the development of generalizable neuroimaging foundation models.\ Code Availability: The source code used in this study is publicly available at this https URL
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https://arxiv.org/abs/2609.30708
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Training-Free Contextual ASR via SpeechLLM-Based Error-Aware Selective Retrieval
2026-09-25 02:00:44Natsuo Yamashita, Ai Nemoto, Ryosuke Koichi, Masaaki YamamotoAbstract
Recognition of domain-specific and low-frequency terms remains challenging for automatic speech recognition (ASR). Although contextual biasing can improve their recognition, directly providing a large terminology dictionary introduces many irrelevant biasing terms. Retrieval-based contextual biasing addresses this issue by selecting candidate terms from an external dictionary, but querying many recognized words requires numerous dictionary lookups and may yield poorly targeted candidates. We propose a training-free contextual ASR framework in which a pretrained speech large language model (SpeechLLM) jointly generates an ASR hypothesis and localizes error spans likely to involve domain-specific terms. Only the localized spans are used to retrieve phonologically similar terms from an external terminology dictionary. The same SpeechLLM then re-recognizes the audio conditioned on the first-pass hypothesis and the retrieved terms, without task-specific model training. To assess applicability across domains, we evaluate the framework on medical, air traffic control, and financial speech. The proposed method substantially reduces dictionary queries while improving the recall and ranking of relevant terminology candidates and second-pass ASR performance across all three domains.
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https://arxiv.org/abs/2609.30694
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BioEVAL: A global, multi-institutional benchmark of large language and multimodal models for bioengineering
2026-09-24 19:26:39Shun Ye, Vinny Chandran Suja, Chenlong Li, Chongming Jiang, Reza Zamani, Xiang Li, Christopher Bain, Yuqi Zhou, Walker Peterson, Huidong Wang, Chenglang Hu, Jongchan Park, Xiao Cheng, Benjamin Swedlund, Sandra Murillo, Anjali Sivanandan, Shiyu Sun, Liang Lanfeng, Mohammad Tariqul Islam, Baju C. Joy, Ishaq N. Khan, Sreedhar S. Kumar, Gabriel Mercado-V\'asquez, James V. Vizzard, Jonathan M. Matthews, Helen Huang, Xiaolu Guo, Ethan Nicklow, Guorui Chen, Ryan A. Neff, Surjendu Maity, Hyeonjin Park, Han-ho Joo, Katherine Dong, Yuyan Cai, Weihang Huang, Yichen Zou, Rui Yan, Raphael Figueroa, Artem Goncharov, Bella Rose Schremmer, Lian Elsa Linton, Keisuke Goda, Liang Gao, Ke Cheng, Leonardo Morsut, Jennifer L. Wilson, Jianping Fu, Lim Chwee Teck, Deblina Sarkar, Andreas Hierlemann, Sava\c{s} Tay, Alexander Hoffmann, Donald Richieri Griffin, Jun Chen, Shana O. Kelley, Shyni Varghese, Jinwoo Cheon, Wilbur A. Lam, James J. Moon, Wilson W. Wong, Samir Mitragotri, Dino Di CarloAbstract
Large Language Models (LLMs) have demonstrated historic breakthroughs in general reasoning with early successes in biomedical science. However, existing LLM benchmarking emphasizes factual recall, offering limited insight into model performance on frontier and multimodal tasks. We assembled BioEVAL (BioEngineering Validation of AI and LLMs), a global, multi-institutional initiative designed to assess experimental reasoning capability across bioengineering (BE) subfields. BioEVAL spans 11 major BE subfields plus a set of uncategorized items, bringing together 22 research groups to create a PhD-level benchmark comprising 608 evaluation items: 1) 380 multiple-choice questions (MCQs, 359 retained after audit), 2) 218 literature synthesis tasks, and 3) 10 multimodal problems with experimental image interpretation. Benchmark items underwent authoring-group expert review and centralized quality control before evaluation. Following evaluation, a blinded cross-group consensus audit of the highest- and lowest-accuracy MCQ items flagged 21 questions for revision or removal; these were withheld, and all reported MCQ results are computed on the 359 retained items. We evaluated diverse cloud-scale foundation/multimodal models (e.g., ChatGPT, Gemini, and Grok) and locally deployable models suitable for inference on consumer-grade GPUs. Models achieved the highest accuracy of up to 90% on MCQs, similarity score of 0.72 on literature synthesis, and accuracy of 80% on a small sample of multimodal reasoning questions, with substantial performance variation across subfields. Leaderboard rankings characterize current capabilities, limitations, and development priorities across the evaluated BE task categories. BioEVAL is maintained as an extensible benchmark with standardized protocols for continuing expert item contribution and model evaluation.
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URL
https://arxiv.org/abs/2609.30489
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Where Does Retrieval-Based Open-Ended Evaluation Fail? Automatic Taxonomy Induction from Long-Form Medical Answer Factuality Verification
2026-09-24 19:04:23Heyuan Huang, Jirui Dai, Alexandra DeLucia, Sonal Joshi, Mahsa Yarmohammadi, Jie Gao, Bernal Jim\'enez Guti\'errez, Mark DredzeAbstract
Retrieval-based factuality evaluation, where LLM-generated claims are verified against evidence from authoritative medical corpora, has become the dominant paradigm for scalable hallucination detection in high-stakes clinical settings. Despite the urgency of reliable and transparent medical fact verification, most systems measure performance with aggregate metrics like F1, which obscure where and why failures occur. Existing RAG diagnostics require gold answers or annotated gold evidence, neither of which exists in this regime. We introduce two comprehensive taxonomies, grounded in a case study on the open-ended MedExpert dataset and 3 closed-ended datasets, decomposing failures into retrieval-stage errors along five quality dimensions, and verifier-reasoning errors into six consecutive steps. We adapt an automatic pattern induction pipeline using LLM-as-Judge to label evidence quality and classify verifier reasoning errors at scale, and then stress-test our findings across 4 retrieval methods and 6 frontier verifier models. Our analysis reveals that scaling model size, adding reasoning effort, expanding to authoritative web sources, and applying medical fine-tuning do not resolve these failure modes, demonstrating that they represent fundamental limitations of the retrieve-then-verify paradigm in open-ended medical settings rather than artifacts of outdated systems. We release our code and data at this https URL for the full reproducibility of our results.
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https://arxiv.org/abs/2609.30467
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Multi-Resolution Feature Fusion U-Net for Magnetic Resonance Imaging Segmentation
2026-09-24 17:46:10Eirini Cholopoulou, Dimitrios E. Diamantis, Dimitris K. IakovidisAbstract
The segmentation of anatomical structures in medical images and particularly in MRI scans, is essential for clinical diagnosis and monitoring disease progression. While Deep Learning (DL) architectures, such as U-Net and its extensions are very effective in medical image segmentation tasks, they often struggle with preserving fine-grained details and global contextual information. This is especially challenging for MRI data segmentation, where anatomical structures are characterized by irregular boundaries and variations in shape, contrast, and scale. To address this challenge, we propose a novel DL architecture for MRI segmentation across different anatomical structures. Specifically, the architecture introduces a module, named Multi-Resolution Feature Fusion (MRFF), that can be easily integrated into any U-Net-like architecture. The MRFF is integrated in all levels of an encode-decoder structure, along with attention mechanisms and skip connections to extract features at multiple resolutions, enabling the model to capture both fine-grained details and global contextual information. We evaluate the MRFFU-Net on two publicly available benchmark MRI datasets of different anatomical targets; one for Cerebrospinal Fluid (CSF) segmentation in spinal MR scans, and one for left atrium cardiac segmentation, from the Medical Segmentation Decathlon (MSD) challenge. Experimental results indicate that MRFFU-Net outperforms state-of-the-art models across multiple evaluation metrics, demonstrating its effectiveness in MRI segmentation.
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https://arxiv.org/abs/2610.00279
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NNV3: Expanding Neural Network Verification to New Architectures and Domains
2026-09-24 16:11:25Anne M. Tumlin, Samuel Sasaki, Ben Wooding, Diego Manzanas Lopez, Muhammad Usama Zubair, Navid Hashemi, Hongchao Zhang, Waseem Abbas, Ipek Oguz, Meiyi Ma, Taylor T. JohnsonAbstract
We present NNV3, the latest version of the Neural Network Verification (NNV) tool, a MATLAB framework for formal verification of deep learning models and learning-enabled cyber-physical systems. Building on the set-based reachability foundation of NNV 1.0 (FFNNs, CNNs, NNCS) and NNV 2.0 (RNNs, SSNNs, neural ODEs), NNV3 introduces new members of the Star-set family: ModelStar for verifying networks under weight perturbation, VolumeStar for video and 3D volumetric inputs, and GraphStar for graph neural networks. A conformal-inference-based probabilistic reachability mode complements sound analysis for problems where deterministic verification is intractable, while FairNNV certifies counterfactual and individual fairness properties over continuous input regions. NNV3 introduces new benchmarks for malware detection, graph-based power-system models, medical imaging, variable-length time series data, and action recognition. NNV3 also incorporates tutorials and developer guides through a unified documentation site. This paper details these major updates, demonstrating NNV's maturation into a comprehensive, robust, and accessible verification tool for a diverse range of AI systems.
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https://arxiv.org/abs/2609.30050
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Synthetic Hospital: An Open, Verifiable, Physician-Validated Longitudinal EHR Benchmark
2026-09-24 16:00:56Christine Park, Valerie Chen, Tim DettmersAbstract
Frontier language models are rarely used in clinical workflows because the realistic, longitudinal benchmarks needed to develop them are scarce. Real electronic health record (EHR) data cannot be openly shared due to privacy, ethics or data use issues and it does not contain verifiable ground truth since the chart records only reflect what clinicians documented. We introduce Synthetic Hospital, an open, fully synthetic, fact-grounded longitudinal EHR benchmark that resolves the open sharing and verifiable ground truth barriers. Built entirely from public medical-education material with no protected health information, it comprises 1,268 longitudinal patients and 5,602 encounters, where every diagnosis, finding, and temporal relation is grounded in standard ontologies (ICD-10-CM, SNOMED CT, LOINC) and with a complete provenance chain back to its source medical education material. Synthetic Hospital is served through a simulated hospital record system that mirrors real EHR infrastructure (standard interoperability APIs, role-based access and function-calling interface). In a blinded review, physicians distinguished its records from real patient charts at near-chance rates (53\%). Across 10 frontier and open models, none approaches ceiling: the best model reconstructs a patient's longitudinal problem list with a severity-weighted F1 of 0.73, level with the mean of seven physicians on a matched subset but well below the best of them (0.89), and misses roughly half of clinically relevant findings when summarizing a chart. Overall, these results highlight that Synthetic Hospital is a difficult and realistic test of clinical AI performance.
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https://arxiv.org/abs/2609.30027
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Lightweight Vision Transformer-Based U-Net for Brain Tumor Segmentation from MRI
2026-09-24 13:26:08Sheekar Banerjee, Md. Srabon Chowdhury, Md. Mahbub Hasan Akash, Ishtiak Al MamoonAbstract
Accurate brain tumor segmentation from Magnetic Resonance Imaging is essential for diagnosis, treatment planning, and surgical guidance. Although Convolutional Neural Networks, particularly UNet, have achieved significant success in medical image segmentation, they often struggle to capture the long-range spatial dependencies required to model tumors with irregular shapes and complex boundaries. This paper proposes a lightweight Vision Transformer UNet that combines the hierarchical feature extraction capability of UNet with the global context modeling of Vision Transformers. The proposed architecture incorporates a compact ViT bottleneck within a U-Net encoder-decoder framework, enabling effective learning of both local and global features while maintaining computational efficiency with only 2.6 million trainable parameters. The model was evaluated on the TCGA LGG MRI Segmentation dataset, achieving a mean Intersection over Union of 0.8100 and a Dice score of 0.8446, outperforming the baseline UNet by 3.75% and 3.15%, respectively. Extensive quantitative and qualitative analyses, including confusion matrix evaluation, precision recall curves, per-image performance distribution, and tumor size dependency analysis, demonstrate the effectiveness and robustness of the proposed method for brain tumor segmentation.
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https://arxiv.org/abs/2609.29785
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A Multimodal Dataset for Survival Prediction in Resected Pancreatic Ductal Adenocarcinoma
2026-09-24 12:41:42Anh-Tien Nguyen, Mawuko Tettey, Jacqueline Michelle Metsch, Teresa Zimmer, Niklas Ullrich, Mario Duker, Sandra Rungeling, Kirsten Reuter-Jessen, Tessa Rosenthal, Lena-Christin Conradi, Michael Ghadimi, Alexander Konig, Elisabeth Hessmann, Volker Ellenrieder, Philipp Strobel, Hanibal Bohnenberger, Anne-Christin HauschildAbstract
Survival research in pancreatic ductal adenocarcinoma (PDAC) is limited by the scarcity of datasets linking whole-slide histology with clinical, molecular, and long-term outcome data. We present a retrospective single-centre cohort of 302 patients who underwent PDAC resection at University Medical Center Gottingen. The dataset comprises 446 H&E whole-slide images, clinicopathological variables, targeted sequencing data for 154 patients, and overall-survival outcomes. During follow-up, 253 patients died, and the median follow-up was 76 months. To establish initial reference values, we evaluated fourteen survival-prediction configurations using identical five-repetition Monte Carlo cross-validation partitions. Ridge Cox regression using numeric clinicopathological variables achieved a mean concordance of $0.649 \pm 0.042$ and $0.652 \pm 0.046$ after adding KRAS and TP53 mutation status. The image-only attention model achieved $0.603 \pm 0.030$, while multimodal fusion achieved $0.619 \pm 0.025$, the highest concordance among the neural models. These results establish promising initial benchmarks for future research using this pancreas-specific multimodal dataset, paving the way for external validation.
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https://arxiv.org/abs/2609.29726
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A Study of the Limits of Collaborative DCT-Based Image Denoising via Interpretable Neural Networks
2026-09-24 10:07:59Cristian Comellas, Julia Navarro, Antoni BuadesAbstract
Image denoising remains a fundamental problem in image restoration, with applications in photography, biomedical, and scientific imaging. Modern deep neural networks achieve strong performance by learning powerful image priors, but often rely on large black-box models with limited interpretability. In contrast, DCT-based sliding-window and collaborative filtering methods such as BM3D offer clear algorithmic structure, but depend on handcrafted and non-differentiable operations. This work studies how far such structured collaborative filtering principles can be pushed when reformulated as trainable models. We introduce DeepBM3D, a compact fully differentiable architecture that combines non-local patch grouping, DCT-domain filtering, and multi-stage refinement within a BM3D-inspired pipeline. Lightweight convolutional feature extractors guide patch grouping, while filtering is performed through learned Wiener weights in the DCT domain. Experiments show that DeepBM3D improves over classical and hybrid baselines, remains competitive with FFDNet at low and moderate noise levels, and performs particularly well on repetitive textures.
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https://arxiv.org/abs/2609.29334
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Multimodal Routing and Region Refinement for Language-Guided Medical Image Segmentation
2026-09-24 00:03:02Md Maklachur Rahman, Md Hasan Al Banna, Saraf Anjum, Assame Arnob, Tracy HammondAbstract
Textual descriptions can reduce ambiguity in medical image segmentation by specifying the finding and location to be delineated. Existing text-guided methods mainly improve where image and language features interact but generally retain a single learned update pathway across all image-text pairs. We propose MRSeg, a parameter-efficient framework that uses each image-text pair to route the adaptation of visual and textual features before dense prediction. Frozen ConvNeXt-Tiny and PubMedBERT encoders provide multiscale visual features and clinical text tokens. A joint router uses the deepest visual feature and pooled text to predict a sparse mixture over low-rank adapter bases. The resulting route is shared across separate adapter banks for two visual scales and text, coordinating their adaptation while keeping the feature-specific parameters separate. Region Bridge uses text-derived queries to aggregate dense visual tokens into latent regions, refines these regions through self-attention and text cross-attention, and redistributes the refined information back to the feature maps. Finally, a multiscale decoder combines refined semantic features with shallow image evidence. On QaTa-COV19 and MosMedData+, MRSeg achieves 90.90/83.32 and 81.53/68.82 Dice/mIoU, respectively, with 7.11M trainable parameters and 7.60 GFLOPs. Code: this https URL.
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URL
https://arxiv.org/abs/2609.28860
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Looks the Same, Answers Differently: Flip-Direction Steering for Robust Vision-Language Reasoning
2026-09-23 23:43:26Yeonsung Jung, Joonhyun Jeong, Hoang Pham, Joowon Kim, Yoonsik Park, Viet Dac Lai, Eunho YangAbstract
Vision-language models (VLMs) achieve strong visual reasoning performance, yet subtle changes from routine image capture and processing can alter their reasoning trajectories even when images appear nearly identical. In long-horizon generation, the resulting activation shifts may accumulate across decoding steps, progressively altering reasoning tokens and ultimately changing the final answer, a phenomenon referred to as answer flips. To address this instability, we propose FlipDir (Flip-Direction Steering), a training-free inference-time method that estimates a low-rank flip-inducing activation subspace from contrastive pairs of original and answer-flipping inputs and selectively steers hidden states during decoding. A margin-based gate limits subspace attenuation to uncertain decoding steps, recovering original predictions while preserving stable ones. To evaluate robustness beyond accuracy or consistency on fixed test sets, we introduce VisFlip, a benchmark framework that constructs evaluation groups for a target model and visual variation setting to separately assess recovery of original predictions and preservation of stable ones. VisFlip spans nine dataset-variation combinations across scientific reasoning, robot-scene understanding, and medical VQA, covering subtle visual variations common in each domain. Experiments across 18 settings demonstrate that FlipDir consistently outperforms existing methods on the combined recovery and preservation metric. We will make our code publicly available.
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https://arxiv.org/abs/2609.28851
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LightMIS: Ultra-Lightweight Medical Image Segmentation Without a Stage-Wise Decoder
2026-09-23 16:05:21Andrei Arhire, Mihaela-Elena Breab\u{a}n, Radu TimofteAbstract
We present LightMIS, a scalable family of ultra-lightweight convolutional networks for 2D binary medical image segmentation without a learned stage-wise decoder. LightMIS aligns the outputs of a five-level encoder to a common resolution using Scale-Aligned Projection blocks, aggregates them once, and refines the fused representation with an Adaptive Fusion Cascade. The cascade combines Adaptive Kernel Fusion with the proposed Progressive Receptive Fusion module, which uses temporary channel expansion, complementary depthwise receptive fields, and progressive cross-branch information transfer. We evaluate LightMIS-T, LightMIS-S, and LightMIS using five-fold cross-validation under a common nnU-Net v2.3.1 protocol on DRIVE, Kvasir-SEG, DSB18, BUSI, ISIC-2017, and ISIC-2018. Full LightMIS contains 0.131 M parameters and requires 0.575 GFLOPs for a $3\times256\times256$ input, achieving modality-macro Dice and IoU scores of 86.71% and 78.99%, respectively. Mobile U-ViT obtains 86.75% Dice and 79.07% IoU, so the observed differences are 0.04 and 0.08 percentage points. Relative to Mobile U-ViT, nnWNet, and nnU-Net, LightMIS reduces parameter count by 90.58$-$99.61% and GFLOPs by 82.54$-$96.14%. On an Arm Mali-G52 MC2 GPU, all LightMIS variants achieve full GPU delegation, with median delegated latency ranging from 53.31 ms for LightMIS-T to 138.31 ms for LightMIS. These results demonstrate a favorable accuracy$-$complexity trade-off and on-device execution feasibility for the evaluated tasks. The code is publicly available at this https URL.
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https://arxiv.org/abs/2609.28327
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Fed-ReMasker: Federated Tabular Imputation under Feature-Level Missingness
2026-09-23 13:37:34Ioannis Papathanail, Rooholla Poursoleymani, Lubnaa Abdur Rahman, Stavroula Georgia MougiakakouAbstract
Multi-center clinical studies and biomedical research collaborations increasingly seek to utilize data across centers to build models that generalize beyond any single center. This creates two distinct challenges: data protection regulations may restrict the sharing of raw patient data across institutions, while centers may collect only partially overlapping sets of features under different protocols. Federated learning enables collaborative model training without centralizing raw data. However, existing federated imputation methods rarely evaluate feature-level missingness, in which entire features are unobserved at some centers. To address this setting, we adapt the ReMasker masked autoencoder to federated learning (Fed-ReMasker), enabling centers to impute features never observed locally by leveraging knowledge learned across collaborating centers. We evaluate Fed-ReMasker in a benchmark spanning synthetic datasets with linear and nonlinear relationships and real-world tabular datasets, including clinical data. The benchmark varies the number of centers, the missingness ratios, and client heterogeneity. Fed-ReMasker achieves the lowest imputation error in 93.2% of value-level and 96.7% of feature-level scenarios in the homogeneous benchmark. It also remains robust to client heterogeneity using simple federated averaging, outperforming all baselines in all 36 value-level scenarios and each baseline in at least 35 of 36 feature-level scenarios, and comes within 3.0% on average of a centralized model trained on the pooled data.
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https://arxiv.org/abs/2609.28105
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Beyond Information Seeking: Severity-Aware Question Supervision for Proactive Medical Dialogue
2026-09-23 12:12:17Chenxuan Li, Xinrong Chen, Luyan Zhang, Peidong Jia, Runfan Zheng, Zhongyu Zhao, Xuecheng Shang, Peixing WanAbstract
Proactive medical dialogue requires an agent to decide what to ask from incomplete patient information. Existing information-seeking approaches commonly prioritize questions that most reduce diagnostic uncertainty, but this criterion overlooks an important property of medical diagnosis: different diagnostic errors can carry substantially different consequences. The most informative question may therefore differ from the one most valuable for the downstream decision. We propose Expected-Severity-Risk (ESR), a consequence-aware question-supervision objective that values each candidate by its expected reduction in severity-aware terminal risk. Because questions must be selected before their answers are observed, ESR marginalizes over possible answers using train-only population statistics. Its rankings are then distilled into a prefix-only language policy, requiring no teacher-side risk computation at deployment. Across three matched Qwen3-4B training seeds on DDxPlus, ESR reduces mean high-severity diagnostic miss from 0.0645 to 0.0455 (29.5% relative reduction) and improves mean diagnostic accuracy from 0.9123 to 0.9320 while requiring only 0.14 additional questions per dialogue. Fixed-budget analyses show that the distinction persists when question count is controlled, while a matched expected-0/1-risk student control further isolates the contribution of asymmetric severity weighting. These results support moving proactive medical dialogue beyond uncertainty reduction toward consequence-aware evidence acquisition.
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URL
https://arxiv.org/abs/2608.24521
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Pre-training, Reasoning, Benchmarking: X-ray Report Generation on CheXpert Plus Dataset
2026-09-23 10:35:18Xiao Wang, Yuxiang Zhang, Dan Xu, Yuehang Li, Shiao Wang, Bo Jiang, Yaowei Wang, Yonghong Tian, Jin TangAbstract
X-ray image-based Radiology Report Generation (RRG) constitutes a critical research direction within medical artificial intelligence, with great potential to alleviate clinicians' diagnostic workload and shorten patient waiting periods. Despite substantial advances over recent years, the field faces evident bottlenecks stemming from insufficient standardized benchmarks and inadequate domain adaptation of generic large models. Notably, the newly released CheXpert Plus dataset is provided without accompanying baseline implementations and evaluation results, which impedes standardized training, quantitative evaluation and fair comparison among follow-up algorithms. To mitigate this limitation, we establish a comprehensive benchmark encompassing prevailing X-ray report generation models and Large Language Models on CheXpert Plus. This benchmark delivers a reliable comparative foundation for upcoming methods and enables researchers to rapidly identify state-of-the-art approaches within this domain. Beyond benchmark construction, we rethink X-ray RRG under the paradigm of large models and propose a novel framework termed MambaXray-PRB. Our framework improves report generation performance and enhances model interpretability via multi-stage large-model pre-training and multi-modal Chain-of-Thought reasoning. The pipeline consists of three successive phases: self-supervised auto-regressive modeling, X-ray-report contrastive learning, and post-training optimization for reasoning and report generation. Extensive experiments on IU X-ray, MIMIC-CXR, and CheXpert Plus datasets validate the effectiveness of MambaXray-PRB for radiology report generation. The source code of this paper is available on this https URL
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URL
https://arxiv.org/abs/2610.08813
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Can Jev Judge Radiology Reports? Evaluating a System One Model for Clinical Factuality
2026-09-23 09:26:46Jiaju Huang, Hao Yang, Xinyu Ma, Xinglong Liang, Kunyan Cai, Junqiang Ma, Shaobin Chen, Yue Sun, Tao TanAbstract
An AI-generated radiology report can resemble a physician's report while omitting an abnormality, adding an unsupported finding, or reversing its presence. Measuring these factual differences is essential for evaluating report generators. We study Jev, a System One decision model, as a simple, low-cost judge of agreement with physician-written reference reports. Our evaluator checks whether each statement is supported by the other report and combines these judgments in both directions to capture unsupported claims and omissions. A single-question configuration reaches Kendall correlations of 0.573 on RadEvalX and 0.398 on RadEvalExpert with expert error counts, outperforming an open natural language inference judge under matched decomposition and aggregation. One support question per statement retains similar expert agreement to seven while using 43-45% fewer judgment input tokens. At the documented API price, judgments cost under three cents per hundred report pairs, excluding local decomposition. In a separate controlled-error test, Jev detects false negation with an AUROC of 0.977. Local RadMatch achieves stronger agreement on clinically significant errors in both expert datasets and on total errors in the shared RadEvalExpert subset. Finding-count and error-scope analyses show that benchmark agreement reflects report size and error definitions as well as medical error detection. These results support Jev as a practical judgment component for measuring factual differences in generated radiology reports and identify where more elaborate evaluation remains valuable.
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https://arxiv.org/abs/2609.27607
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