Medical
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MedVA: An End-to-End Neuro-Symbolic Agentic System for Medical Volume Visualization
2026-09-14 00:48:16Haill An, Suhyeon Kim, Minjun Kang, Eunwoo Lee, Bin Sheng, Lei Bi, Younhyun JungAbstract
Medical volume visualization requires selecting regions of interest (ROIs) and carefully controlling their relative visual emphasis according to a given clinical intent. Implementing these decisions in conventional workflows demands substantial clinical and visualization expertise and often involves trial-and-error optimization. Recent agentic systems have introduced natural-language interaction and autonomous visualization operations but largely rely on MLLM-based inference throughout the workflow. Although MLLMs encode broad medical knowledge and provide strong reasoning capabilities, such inference may be suboptimal for medical volume visualization, potentially leading to clinically incomplete interpretations of user requests and unreliable ROI identification and visualization optimization. In this work, we present MedVA, an end-to-end neuro-symbolic agentic system for medical volume visualization that addresses these limitations through three complementary agents. The neuro-symbolic intent formulation agent refines MLLM-based interpretations of natural-language requests through symbolic reasoning over established clinical knowledge, which provides more complete, clinically grounded ROI specifications than MLLM-only reasoning. The multi-model ROI identification agent directly identifies semantically specified ROIs in the original volume by leveraging complementary large-scale pretrained medical segmentation models. The objective-driven visualization optimization agent explicitly evaluates ROI visibility and occlusion in the original volume using a volume-based visibility objective. Extensive agent-level and system-level evaluations across diverse medical datasets and interaction scenarios support the effectiveness of the individual agents. A formative user study further indicates high usability and practical value among users with different levels of expertise.
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URL
https://arxiv.org/abs/2609.14874
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MedTRACE: Tool-Augmented Multimodal Clinical Reasoning Agents for Evidence-Grounded Decision-Making
2026-09-13 22:32:49Ji Lu, Lifei Liu, Haoran Yu, Xianglong Wang, Yiru Fang, Kuo Yang, Huiran Duan, Jianping GouAbstract
Multimodal clinical decision-making requires reliable reasoning over heterogeneous evidence from electronic health records, medical images, and physiological signals. Existing models typically map these inputs directly to diagnoses without explicitly assessing evidence sufficiency, tool-use requirements, or diagnostic uncertainty. This paper presents MedTRACE, a tool-augmented multimodal clinical reasoning agent for evidence-grounded decision-making. MedTRACE uses modality-specific encoders to construct a unified patient-state representation and performs an iterative loop of hypothesis formation, toolaware deliberation, and evidence verification. It dynamically invokes visual grounding, evidence retrieval, and structured parsing tools to locate diagnosis-relevant regions, retrieve clinical knowledge and similar cases, and extract structured findings. The acquired evidence enters an evidence memory, where a consistency verifier confirms or revises the current hypothesis. MedTRACE outputs a diagnosis together with supporting evidence, an auditable reasoning trace, and calibrated confidence. Experiments on multiple multimodal clinical diagnosis benchmarks show that MedTRACE improves diagnostic accuracy by 5.4% and AUROC by 4.7 percentage points over the strongest baseline. It also improves evidenceselection F1 by 8.2 percentage points and visual-grounding IoU by 6.5 percentage points, reduces expected calibration error by 31.6%, and decreases unsupported diagnostic errors by 27.8%. These results demonstrate that active evidence acquisition and verification improve the accuracy, interpretability, and reliability of multimodal clinical decisionmaking.
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URL
https://arxiv.org/abs/2609.14823
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Beyond Natural Images: Rethinking AI-Generated Image Detection in Documents
2026-09-13 07:26:45Zhangjie Fu, Jiazhen Yan, Yuanwen Chen, Xinquan Yu, Yanzhe Li, Hui Jiang, Lei Gao, Chenfu BaoAbstract
AI-generated image detection has attracted increasing attention, but existing evaluations mainly focus on natural images, leaving AI-generated document images largely underexplored. This omission is concerning because documents often appear in sensitive real-world scenarios, such as invoices, expense reports, certificates, and medical records. In this paper, we first construct a controlled diagnostic benchmark, AIGDoc-Pilot, and reveal that existing detectors suffer substantial performance degradation on AI-generated document images, with the mean AUC dropping by more than 7%. Based on this, we further reveal two document-specific properties behind this gap: generation artifacts exhibit strong spatial inconsistency across local regions, and text density significantly affects real-synthetic separability, where text-dense regions offer stronger discriminative evidence. Motivated by these findings, we construct AIGDoc, a larger document-centric dataset containing diverse real-world documents and AI-generated counterparts produced by multiple advanced generation and editing models. Extensive experiments on AIGDoc demonstrate that existing detectors still struggle to reliably identify AI-generated documents, while document-based training partially narrows the gap. Together, these results offer valuable insights for developing dependable and generalizable detectors in document-centric scenarios. The code and datasets will be made publicly available upon acceptance of the paper.
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URL
https://arxiv.org/abs/2609.14352
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Two-Stage Mixture-of-LoRA for Multi-Task Medical Vision-Language Learning
2026-09-13 07:23:52Zhanghao Chen, Yuanyuan Li, Zhenyu Lu, Shuo Gao, Guangquan Zhou, Yikun ZhangAbstract
Medical vision-language models (VLMs) allow a single model to perform clinical image analysis tasks ranging from diagnosis classification to report generation. However, joint adaptation is challenged by heterogeneous output formats, conflicting task gradients, and imbalanced training data. Hence, we present \textbf{Two-Stage Mixture-of-LoRA}, a framework built on MedGemma-1.5-4B. The framework uses a shared-specific Mixture-of-LoRA architecture comprising one shared LoRA and six task-specific expert LoRAs, together with a two-stage training procedure. In Stage 1, we jointly train the shared LoRA and all task-specific expert LoRAs on all tasks. In Stage 2, we first freeze the backbone, the shared LoRA, and all non-target experts, and refine one task expert at a time. Classification and regression then receive an additional modality-balanced continuation, in which smaller modality groups are repeated to match the largest group. In the FLARE 2026 Task 3 test sets, the proposed method achieves 0.85 balanced accuracy for classification, 0.48 micro-F1 for multi-label classification, 0.79 detection F1, and 17.39 regression MAE. Code is available at this https URL.
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URL
https://arxiv.org/abs/2609.14350
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Performance vs Consistency: Evaluating a Foundation Model in Lung-RADS Screening
2026-09-13 02:43:46Benjamin Renoust, Pierre Baudot, Tiffany Foriel, Yousra Haddou, Charles Voyton, Pierre-Henri Siot, Ezequiel Geremia, Danny Francis, Jean-Christophe Brisset, Val\'erie Bourd\`es, Sylvain Bodard, Benoit HuetAbstract
Foundation models have recently demonstrated strong capabilities across a wide range of medical imaging tasks. However, their performance in structured clinical interpretation settings remains insufficiently explored. In lung cancer screening, interpretative variability persists despite standardized frameworks such as Lung-RADS. In this study, we evaluate MedGemma, a medical general-purpose foundation model derived from Gemini and its fine-tuned version adapted for lung cancer detection and diagnosis, compared against radiologists performing Lung-RADS v2022 assessment on the NLST dataset. Twelve radiologists independently evaluated each case in a multi-reader design, enabling quantification of inter-reader variability. Radiologists achieved a mean AUC of 0.90, with substantial variability across readers (range: 0.80-0.94). The native foundation model achieved an AUC of 0.70, failing to reach clinically relevant performance. In contrast, fine-tuning significantly improved performance to an AUC of 0.83, placing the model within the lower range of individual radiologists performance. These findings highlight a trade-off between peak accuracy and prediction consistency. Unlike radiologists, under fixed conditions, the model produces deterministic outputs, removing inter-run variability under identical inputs, in contrast to inter-reader variability observed among radiologists. This supports the role of fine-tuned foundation models potential complementary tools for clinical decision support, particularly in settings with limited expertise. However, evaluation is performed on a case-enriched cohort from NLST and does not account for real-world prevalence or external validation, limiting direct clinical generalization.
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URL
https://arxiv.org/abs/2609.22281
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To do or not to do: Medical Image Counterfactuals for Dataset Augmentation
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Medical image analysis is often hindered by biased datasets, which can lead to biased models and limited clinical applicability. A promising strategy for mitigating such biases is to augment training data with synthetic images. Counterfactual (CF) generation is one such strategy, though the term is used in two different senses: in some works, CFs are produced through causality-based interventions derived from structural causal models, whereas in others, they are produced by non-causal image edits or conventional conditional generative models, such as altering anatomy or adding pathologies. In this work, we study this distinction and evaluate its practical consequences for medical image augmentation. We compare three conditioning strategies: $\textit{Deterministic}$, which changes selected variables while holding the remaining variables fixed; $\textit{Undirected}$, which updates variables according to learned statistical associations without assigning causal directions; and $\textit{Causal}$, which propagates interventions along a directed causal graph. We analyse how these choices affect the resulting images, and explore when causally grounded methods improve dataset augmentation or bring limited benefit. In particular, we assess downstream performance and fairness, where fairness refers to reduced sensitivity to dataset biases across sensitive subgroups. Our experiments demonstrate that using a causal approach to synthetic training data generation can lead to tangible benefits, with these insights offering valuable guidance to machine learning practitioners for the effective design of data generation protocols.
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URL
https://arxiv.org/abs/2609.14124
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A Voxel-Spacing-Aware Extension of PyRadiomics for Anisotropic Texture Analysis
2026-09-12 18:59:08David Corral Fontecha, Juan Miranda Bautista, Pablo Menendez Fern\'andez-Miranda, Andrea Trapote Fernandez, Lara Lloret Iglesias, Jose A. VegaAbstract
Radiomic texture features are commonly extracted from anisotropic CT and MRI acquisitions, where identical voxel offsets may represent different physical distances. We implemented and validated a voxel-spacing-aware extension of PyRadiomics that incorporates spacing information without generating interpolated gray levels. The framework operates across the Python frontend, C wrapper, and computational backend. GLCM uses anisotropy-relative feature-level angular aggregation, NGTDM uses anisotropy-relative weighted neighborhood averaging, and GLRLM, GLDM, and GLSZM are computed on a finite-volume zero-order-hold representation derived from the native anisotropic grid. Synthetic 3D phantoms were used for software validation. The modified implementation reproduced standard PyRadiomics exactly when spacing-aware mode was disabled and remained equivalent under isotropic spacing across 75 texture features. Under anisotropic spacing, the method selectively modified texture families and was numerically distinct from nearest-neighbor, linear, and B-spline resampling. Computational profiling showed moderate runtime and memory increases, while sensitivity analyses quantified finite-volume rounding effects and confirmed that spacing-aware differences persisted across binWidth settings. The framework provides a backward-compatible technical basis for future evaluation of spacing-aware radiomics in heterogeneous medical imaging datasets.
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URL
https://arxiv.org/abs/2609.14103
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VeriDx: Earning the Right to Diagnose with Disease-Centric Verification
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A correct diagnosis can still be reached for the wrong reasons. In clinical reasoning, every disease hypothesis creates obligations: key evidence must be checked, alternatives must be ruled out, contradictions must be resolved, useful tests must be considered, and closure must be justified. Current evaluations of medical LLMs mostly focus on final answers, local steps, or isolated facts, and therefore miss these hypothesis-induced commitments. We introduce \textbf{VeriDx}, a disease-centric verification framework that links free-form diagnostic reasoning to structured disease profiles. VeriDx tracks whether each hypothesis is satisfied, unresolved, or violated its clinical obligations, exposing failures such as missing critical tests, unresolved differentials, ignored contradictions, unsupported claims, and premature closure. We instantiate VeriDx for complex respiratory diagnosis using guideline-derived disease profiles and expert-annotated longitudinal cases. Our results show that many diagnostic errors are not isolated mistakes, but broken commitments made earlier in the reasoning process.
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URL
https://arxiv.org/abs/2609.14018
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ClinAgent: A ReAct-Based Agent for Conversational Access to Clinical Trial Information
2026-09-12 10:25:35Antonino Vaccarella, Riccardo Cantini, Domenico Talia, Paolo Trunfio, Marianna Talia, Rosamaria Lappano, Marcello MaggioliniAbstract
Querying clinical trial registries remains a manual and error-prone process, requiring researchers to navigate large volumes of semi-structured data without support for natural language interaction or cross-source synthesis. To address this, we introduce ClinAgent, a conversational system based on agentic Retrieval-Augmented Generation (RAG) that enables clinicians and researchers to query clinical trial information in plain language and receive grounded, up-to-date responses across multi-turn interactions. The system centers on a Large Language Model (LLM) agent following the ReAct paradigm, which iteratively reasons over queries, selects among a set of integrated tools, and refines its actions based on intermediate outputs. These tools include a this http URL search interface, a PubMed module, and a Python-based analyzer operating on a locally cached structured dataset of clinical trials. We evaluate the system using a three-phase framework assessing operational effectiveness, planning quality, tool-use efficiency, and expert qualitative judgments, comparing three LLM backends: Gemini 3.0 Flash and two variants of DeepSeek V3.2 (thinking and non-thinking). Results reveal complementary strengths, with DeepSeek (thinking mode) excelling in planning quality, while Gemini achieves the highest overall performance and strongest expert ratings. Overall, our findings highlight the potential of agentic AI systems to improve the accessibility and synthesis of clinical trial information, supporting more efficient and user-centered biomedical research workflows.
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URL
https://arxiv.org/abs/2609.13860
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Understanding the Limits of Agentic ICD Coding
2026-09-12 08:33:38Chong Yock Eng, Yushi Cao, Yiming Chen, Kezhi Mao, Hongchao JiangAbstract
ICD-10-CM codes are alphanumeric codes used in the US to classify diagnoses and injuries for medical billing and epidemiological reporting. Standard ICD-10-CM benchmarks report aggregate metrics that obscure performance on complex coding scenarios. We evaluate neural, workflow, and agentic systems on a rarity-stratified set of MIMIC-IV discharge summaries and identify two orthogonal failure modes. Neural classifiers exhibit a 0.43 micro-F1 gap between rare and common codes. Workflow systems handle rare codes well but score near zero on injury and external cause codes that require multi-step guideline following. A tool-augmented agentic configuration with structured access to official ICD-10-CM reference materials recovers up to 0.34 micro-F1 on this subset. No single system dominates across all conditions.
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URL
https://arxiv.org/abs/2609.13806
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Positioning manuscripts in the scientific landscape with agentic AI
2026-09-12 07:10:14Jiawen Chen, Zichen Zhang, Bingxuan Li, Quan Sun, Yiyan Zhang, Edric Tam, Jinjie Lin, Didong Li, Yun Li, Bingxin ZhaoAbstract
Publishing a research manuscript is a routine yet demanding part of scientific life: time-consuming, stressful, and often uncertain in outcome. Recent advances in large language model (LLM)-based agentic AI have shown promise across a range of scientific tasks, and here we ask whether agentic AI can help researchers navigate the publication process itself by reliably inferring a manuscript's eventual publication venue from its content and literature context. We introduce PASS (Publication-oriented Agentic Scientific System), an agentic system that understands manuscripts within their domain-specific literature context and predicts top-matched publication venues. PASS positions each manuscript within its surrounding literature landscape by reconstructing its local scientific neighborhood, tracing its topic trajectory, and reasoning over field-specific journal spaces. Evaluated on a leakage-audited benchmark of over 2,000 preprints across 16 biomedical fields, PASS achieved Top-1 accuracy of 50.3% and Top-5 accuracy of 86.1%, outperforming state-of-the-art LLM baselines and established journal-selection tools. PASS-produced quality scores, such as impact potential and novelty, aligned with independent measures of publication outcome. We also found that the designed literature retrieval module is the strongest performance contributor, particularly for positioning manuscripts relative to nearby work, and that PASS maintained near-full performance from the abstract alone, whereas LLM baselines required the full manuscript text. An independent human evaluation found strong researcher agreement with PASS's manuscript understanding and recommendation rationale. PASS has been released as a public platform (this https URL) for broad researcher access.
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URL
https://arxiv.org/abs/2609.13760
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Toward Complete Hospital Discharge Summarization with Abstract Meaning Representation
2026-09-11 22:38:34Paul Landes, Sitara Rao, Aaron Jeremy Chaise, Barbara Di EugenioAbstract
Discharge summaries are lengthy medical documents that summarize a hospital in-patient visit. Automatically generating them can reduce documentation burden and return clinician time to patient care. Whereas Large Language Model (LLMs) could be used for this task, their Achilles heel is hallucinations, which can have drastic consequences for clinical documentation. We present an evidence-driven alignment framework for discharge summarization at the clinical encounter level, that treats provenance as a first-class constraint, using semantic graphs and deep learning models. Each summary sentence is selected and organized via cross-document semantic alignment and is accompanied by explicit evidence links to its source spans. We show our results on two corpora: a publicly available corpus (MIMIC-III) and clinical notes written by physicians at the University of Illinois Hospital (UIC Health). Additionally, we make source code and trained models available.
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URL
https://arxiv.org/abs/2609.13581
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Domain-Specific Jargon in Large Language Models: A Comparative Analysis between General-Purpose and Specialist Models
2026-09-11 21:35:04Darin Keng, Zhewei SunAbstract
Large Language Models (LLMs) have shown remarkable proficiency on general-purpose tasks, yet their performance often degrades in highly-specialized technical domains. Moreover, little is known about how parametric knowledge of domain-specific terms is encoded within these models. We address this gap by contributing two novel medical jargon evaluation benchmarks and evaluate a general-purpose Llama-3.1 model against a variant fine-tuned on medical-domain data. Surprisingly, the general-purpose model outperforms the medically fine-tuned model on both tasks. Using mechanistic interpretability tools, we find systematic patterns of miscalibration for the medically fine-tuned model. Instead of reorganizing parametric knowledge, the fine-tuned model places greater emphasis on a small subset of model components associated with jargon-favoring predictions. We find that applying component reweighting strategies against the benchmark tasks successfully suppresses these components and closes the gap with the general-purpose baseline. We also observe that some jargon-sensitive components transfer knowledge to the same tasks involving materials science jargon, suggesting they encode a partially domain-agnostic notion of specialized terminology. Our results provide a case study in which a medically fine-tuned checkpoint does not improve jargon comprehension over its general-purpose counterpart, highlighting that domain adaptation should not be assumed to yield better performance on specialized terminology.
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URL
https://arxiv.org/abs/2609.13556
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Positive Topology and Feasible Refinement: Forcing Matrices, Positivity, and Information
2026-09-11 20:46:32Mirco A. Mannucci, Giovanni SambinAbstract
We develop a conceptual and operational account of Positive Topology starting from a basic relation between points or models and observable properties. From this relation, two complementary structures emerge. The first captures universal refinement and cover: what must hold across all relevant cases and how information can be systematically refined. The second captures positivity and witnessed existence: what can be positively realized and sustained without relying on classical complements. A central result shows that the underlying relation between points and observables can be reconstructed from either of these induced structures. We also clarify the distinction between point-based and pointfree formulations: when points are available, positivity can be derived from the underlying forcing relation, while in the formal pointfree setting positivity is taken as primitive and its compatibility with cover is imposed axiomatically. We develop two complementary interpretations of the framework. The first is information-theoretic, viewing cover as refinement of partial information and positivity as witnessed feasibility. The second is game-theoretic, viewing positivity as the ability of a witness or hypothesis to survive successive legitimate refinements. The final part of the paper is deliberately programmatic. We outline how resource constraints, verification costs, and finite budgets can be incorporated into the framework. This leads to resource-sensitive notions of forcing, cover, positivity, and refinement, and raises new questions about how these structures behave as available resources change. Examples from medical diagnosis, legal reasoning, and AI systems illustrate the potential relevance of the approach to grounded, explainable, and resource-aware inference.
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URL
https://arxiv.org/abs/2609.13523
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A Hybrid Hierarchical 1D-CNN-BiLSTM Framework for Extractive Summarization of Biomedical and Clinical Text
2026-09-11 19:49:33Saad Bin Ather, Muhammad Saif, Ali Hassan Khan, Manzer Abbas, Hajra WaheedAbstract
Large language models have made abstractive summarization remarkably fluent, but generated summaries can hallucinate facts, posing serious risks in biomedical and clinical domains. We address this by removing generation from the pipeline and framing summarization as extractive sentence selection. Our Hybrid Hierarchical CNN-LSTM Summarizer uses stacked multi-kernel convolutions to compose sentence-level embeddings into richer inter-sentence representations, followed by a bidirectional LSTM to model long-range dependencies across the document. A lightweight scoring head assigns per-sentence importance scores and is trained end-to-end with binary cross-entropy against oracle extractive labels. At inference, a dynamic mean-plus-standard-deviation threshold with a top-3 fallback selects sentences directly from the source and chronologically reorders them into the final summary. Since every output sentence is copied from the input, the model avoids generation-induced factual drift. On PubMed, our architecture outperforms isolated CNN and LSTM baselines, while ablations show that wider convolutional receptive fields improve sentence scoring. On MIMIC-CXR and MIMIC-IV BHC, the model performs well on unstructured narratives but defaults toward positional baselines on highly templated reports. These results suggest that structural constraints can provide a reliable path toward factually grounded summarization systems that are trustworthy by design rather than by correction.
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URL
https://arxiv.org/abs/2609.13481
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LabAgent: Customize Any Research Hubs for Scientific Discoveries Using AI Agents
2026-09-11 18:53:18Lei Liu, Yikun Zhang, Jialin Chen, Wanjia Zhao, Rex Ying, Wengong Jin, Hua Xu, James Zou, Tianyu Liu, Hongyu ZhaoAbstract
Scientific research is a continuous process that emphasizes inheritance. Methods developed by predecessors are often expanded upon by new researchers to explore more novel and in-depth scientific questions. However, the change of lab staff, such as student graduation, leads to a lack of personnel capable of replicating methods. Methods that have been developed with significant effort and resources cannot be continued. To address these limitations, we propose LabAgent, a reproduce and discovery harness tailored for a lab's continuous work. LabAgent employs two mechanisms to guarantee that all skills can be executed and verified and to record the corrective methods and experiences, allowing for direct correction or avoidance of similar errors. We applied LabAgent to drug property prediction, biomedical problem analysis, protein variant effect prediction, and statistical genetics in life science domains. LabAgent ranks first over commercial generalist agents in every domain, and demonstrates accurate reproduction of a published figure. Overall, these results demonstrate that LabAgent can effectively integrate and reasonably expand laboratory knowledge.
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URL
https://arxiv.org/abs/2609.13437
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Unified CT and MRI Pancreas Segmentation for Label-Efficient Cross-Modality Subregion Transfer
2026-09-11 16:40:25Ziliang Hong, Hongyi Pan, Halil Ertugrul Aktas, Andrea Bejar, Elif Keles, Frank H. Miller, Michael B. Wallace, Rajesh N. Keswani, Gorkem Durak, Ulas BagciAbstract
Robust medical image segmentation across imaging modalities is challenging because of large differences in appearance and intensity distributions. Models trained on a single modality often show substantial performance drops when applied to unseen domains. In this work, we develop a unified 3D pancreas segmentation framework that applies domain-adversarial learning to 4,604 heterogeneous CT and MRI scans to learn anatomical representations. A shared nnU-Net encoder-decoder is trained for whole-pancreas segmentation, with a latent domain discriminator encouraging CT-MRI feature alignment. The learned encoder is subsequently transferred to pancreatic head-body-tail segmentation using limited MRI-only subregion annotations. An average Dice score of 87.31% on the in-distribution test set and Dice scores ranging from 84.20% to 88.09% across external OOD datasets were achieved in whole pancreas segmentation. Dice scores of 80.53% on MRI and 83.05% on CT were achieved for downstream subregion segmentation, without using CT subregion annotations. These results demonstrate that a unified anatomical representation can support both cross-modality pancreas segmentation and label-efficient downstream transfer.
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URL
https://arxiv.org/abs/2609.13043
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Tasks over Application Manuals: Revealing Gaps in Long-Horizon Procedural Reasoning for Language Models
2026-09-11 16:04:00Utkarsh Soni, Syed Shariyar Murtaza, Yifan Nie, Sachin Chandrasekhar, Eugene WenAbstract
Large language models (LLMs) have achieved strong performance on a wide range of natural language tasks, and recent benchmarks suggest that they are increasingly adept at multi-hop reasoning. However, these benchmarks are typically short-horizon, requiring only a small number of retrieval or inference steps, and provide limited evidence of reliability on real-world tasks that involve following manuals spanning hundreds of pages with complex, interdependent guidelines. In this paper, we introduce Tasks over Application Manuals (TAM), a benchmark for evaluating long-horizon procedural reasoning. We construct TAM by curating real-world tasks from two domains: ICD-10-CM clinical coding (mapping medical conditions to diagnostic codes) and U.S. federal sentencing (computing crime sentencing guideline outcomes, specifically offense levels), with human-validated labels. Each task requires following an authoritative manual with tens of thousands of rules and executing a sequence of interdependent steps across different sections to produce an exact answer. We evaluate general-purpose prompting approaches, including retrieval-augmented generation, ReAct-style prompting, and an agent-harness baseline on GPT-5, and find that the best exact-match performance remains extremely low: 1% on ICD-10-CM coding and 15.5% on sentencing tasks. These results show that current benchmarks may overestimate LLM reasoning ability and miss a key challenge: reliably following long, rule-based procedures. The complete TAM data and code are publicly available.
Abstract (translated)
URL
https://arxiv.org/abs/2609.13005
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Beyond Accuracy: Uncertainty-Guided Boundary Refinement for Reliable Biomedical Image Segmentation
Abstract
Accurate biomedical image segmentation requires not only high global overlap but also reliable delineation of clinically meaningful boundaries. In blood-smear microscopy, cytoplasm and nucleus contours provide the structural basis for downstream morphology analysis; however, deep segmentation models may remain uncertain or overconfident near ambiguous boundary regions even when achieving strong Dice scores. This work proposes a Reliability-Aware Boundary Refinement Network (RABR-Net), a two-stage framework for trustworthy image segmentation. A strong UNet++ EfficientNet-B4 base segmenter first produces initial class probabilities and logits. Predictive entropy, test-time augmentation variance, margin uncertainty, probability gradients, and soft boundary cues are then combined into a boundary-aware reliability representation. This representation guides a gated residual refiner that selectively corrects uncertain boundary pixels while preserving confident regions of the base prediction. The framework is evaluated using overlap accuracy, class-wise Dice, Boundary Dice, HD95/ASSD, calibration, risk--coverage analysis, robustness under image perturbations, qualitative correction maps, and paired statistical testing. On the held-out test set, the proposed method improves Dice from 0.9602 to 0.9614, Boundary Dice from 0.3448 to 0.3611, and HD95 from 3.0354 to 2.8274 compared with the cached base prediction. Statistical analysis confirms significant improvements in Dice, Boundary Dice, and HD95. Qualitative results show that the learned gate concentrates around uncertain cytoplasm and nucleus boundaries, and correction maps confirm localized boundary refinement. Although calibration does not automatically improve after refinement, the proposed framework provides an interpretable and reliability-focused strategy for boundary-sensitive biomedical image segmentation.
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https://arxiv.org/abs/2609.12892
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MedSNIP: Building and Benchmarking Snippet-Level Granularity for Medical Fact Verification
2026-09-11 14:08:44Hasan Iqbal, Sarfraz Ahmad, Hyunjae Kim, Sihyeon Park, Junjie Liao, Qingyu Chen, Preslav Nakov, Yuxia WangAbstract
A medical claim's correctness often depends not on the claim alone, but on the clinical structure around it. A claim may require a lab reference range, a causal or conditional link, or patient-specific details to be judged correctly, and atom-level decomposition can fragment these dependencies, leaving the verifier with clinically incomplete claims. We reformulate medical fact-checking around snippet-level verification, where clause-grouped units preserve local clinical structure. We introduce MedSNIP-Bench, a human-annotated benchmark for snippet-level medical fact verification, and MedSNIP, an automatic snippet-generation pipeline. MedSNIP-Bench covers 276 consumer-health and clinical-vignette responses, segmented into 2,524 snippets with dual in-general and in-patient-context labels and six structural pattern codes. MedSNIP is evaluated against human snippet boundaries on MedSNIP-Bench and then used to generate snippet-level units for external corpora. Across MedSNIP-Bench, HealthFC, and MedHallu, snippet-level verification preserves or improves false-class F1, with gains concentrated where answers are long enough to fragment and where the verifier is strong enough to exploit the recovered structure. The largest merge-pattern gain is on causal-conditional clinical chains. It also reduces verifier calls by 24-73%, though the saving survives end-to-end only when decomposition is cheap, which an open-weight decomposer makes possible at no loss of chunking fidelity.
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URL
https://arxiv.org/abs/2609.12884
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