#01Oct 26, 2026
cs.CL
Understanding Jev-Style System One Models: Does Structure Reduce Selection Bias?
Mingyang Song, Mao Zheng, Zhiyuan Ma and 1 more
Selection bias in large language models (LLMs) can persist despite instructions to ignore presentation order or prompts that elicit reasoning. Recent efforts to reproduce Jev-style System One behavior have produced a growing family of models that predict probabilities directly over supplied candidates. Yet systematic comparisons of selection bias across Jev versions, Jev reproductions, and generative LLMs remain limited in multi-option tasks. This leaves a central question: does Jev-style decision structure reduce selection bias? We address this question with a simple test that shuffles options while keeping question and candidate content fixed. Across two Jev versions, twelve Jev reproductions, and six generative LLMs, we trace individual answers through eight presentations and compare them with fixed-order repetition. On our primary collection of 1,700 questions from two benchmarks, Jev's accuracy varies by less than two percentage points, yet its cumulative failure set expands by 27--29\% relative to the original order, with first failures continuing into the final presentation. This loss of initial successes is substantially larger than under fixed-order repetition, even for highly repeatable Jev reproductions. Nor does Jev show a general advantage over the LLM baselines in preserving correct choices. Aggregation offers limited protection: voting yields modest gains for Jev, while even unanimous answers are frequently wrong. These results expose a gap between repeatable decisions and decisions that remain correct across equivalent presentations, showing why stable accuracy alone cannot establish resistance to selection bias.
#02Oct 26, 2026
cs.AI
Explainable Multimodal AI Approach to Reduce Unnecessary Breast Biopsies
Sadam Hussain, Mansoor Ali, Daly Betzabeth Avendaño-Avalos and 1 more
Recently, there has been rise in multimodal vision-language models for computer-aided diagnosis (CAD), yet their application in breast diagnosis, particularly for predicting biopsy outcomes remains limited. This study presents a multimodal vision-language approach, incorporating Grad-CAM as an Explainable AI (XAI) technique, to predict benign tumors in patients recommended for biopsy, especially those classified as BI-RADS 4 and 5. A novel multimodal framework was devel- oped using Vision Transformer (ViT) for imaging feature extraction and DeBERTa-V3-Large for textual embeddings. The model was trained and evaluated on a comprehensive in-house dataset comprising 1,632 patients, each with four mammography views and a corresponding radiology report. The features of both modalities were extracted independently and fused by late fusion before classification. Grad-CAM was used to generate visual explanations highlighting key regions influencing model predictions. The proposed model demonstrated high sensitivity 90%, 95%, 99%, and 100% with corresponding specificities of 40%, 36%, 18%, and 11%, respectively. The best AUC achieved was 0.72 by multimodal approach on the test set, outperforming the image only (0.66) and text-only (0.68) baselines. The proposed multimodal architecture, enhanced with Grad-CAM, demonstrates a strong potential to identify benign tumors among high-risk patients, offering interpretable insights and thereby helping reduce unnecessary biopsies, patient anxiety, and healthcare costs.
#03Oct 26, 2026
cs.AI
Patient-specific rubric-based evaluation of large language models across longitudinal cancer care
Wei-Wei Zhang, Pengkai Wang, Yan Li and 13 more
Large language models (LLMs) show promise in specialty medicine, yet existing evaluations largely focus on isolated clinical encounters rather than tracking how clinical responsibilities evolve across a longitudinal care pathway. Here we introduce NPC-RubricBench, a phase-aware benchmark for evaluating multistage clinical reasoning across the cancer care continuum, using nasopharyngeal carcinoma as a defined disease context. Curated from longitudinal records of 405 patients across two cancer centers, the benchmark comprises 941 patient-phase units across six sequential care phases and 17,688 patient-specific atomic criteria spanning five evaluation dimensions, with each assessment strictly restricted to decision-time clinical evidence. Evaluating 30 general-purpose and medical LLMs revealed that strong diagnostic performance does not carry over to downstream care. We evaluated 30 general-purpose and medical LLMs, showing that high diagnostic performance did not translate into improved downstream care. Instead, the dominant failure modes reversed across phases. Explicit decision errors dominated anatomical staging at 48.2%, whereas decision omissions dominated initial work-up and post-treatment follow-up at 33.4% and 30.4%, respectively. In the evaluated model set, medically adapted models showed higher omission rates than general-purpose models. Moreover, varying query granularity exposes a critical specification trade-off: broad open-ended requests degrade Decision Quality across all 30 models, while more detailed, checklist-like prompts raise Decision Quality but reduce Evidence Faithfulness and Safety Adherence. Furthermore, NPC-RubricBench demonstrates that static diagnostic benchmarks are insufficient to ensure consistent clinical reliability over time, highlighting the importance of phase-adaptive safeguards in multistage medical AI.
#04Oct 26, 2026
cs.AI
Beyond Physical Illness: Can Clinical Narratives Reveal Emerging Mental Health Risks in Chronically Ill Patients?
Sudeshna Jana, Siddhartha Laha, Manjira Sinha and 2 more
Mental-health risks such as depression, dementia, and suicidal ideation can emerge during hospitalization among chronically ill patients and may worsen without timely recognition and intervention. However, most existing mental health studies focus on patients with established psychiatric conditions rather than patients hospitalized primarily for physical illness. In this work, we investigate whether latent mental-health risk in chronically ill patients can be inferred from longitudinal clinical narratives. We construct a weakly supervised cohort around 4,000 patients from MIMIC-III using mental-health evidence extracted from discharge summaries. A hierarchical state-space framework derives mental-health representations from day-wise clinical narratives and models their temporal evolution for risk estimation throughout hospitalization. Preliminary results demonstrate improved binary risk prediction using the proposed representations and show distinct model derived risk trajectories between risk and no-risk cohorts, providing a foundation for studying emerging mental-health risks in chronically ill patients.
#05Oct 26, 2026
cs.LG
Quantitative Generalization Bounds for Multi-Layer Transformers: A Few Long Strings can Beat Many Short Ones
Marius Henry, Michael Rizvi-Martel, Michael Hahn
Transformer-based language models exhibit an astonishing capacity to generalize to longer and more difficult problem instances than those seen in training. However, theoretical understanding of this phenomenon still lags behind. Unlike most machine learning models, the generalisation abilities of transformers inherently require considering two axes. On one hand, one must examine in-distribution statistical generalisation, which concerns the ability of a model to broaden a function from training samples to novel samples of the same distribution. On the other hand, given the sequential nature of language data, one must also consider length generalisation, which reflects whether a model trained on inputs of a given length can extrapolate to longer ones.These two notions have mostly been studied separately, leaving open how they interact. In this work, we give a joint treatment of both axes for fixed-precision transformers. We give generalisation guarantees in terms of the parameter sizes of the involved models, as well as the quantization space and the alphabet size that supply the sequences. Finally, we illustrate how the requirements in the sample count and training length trade off. In particular, we find that increasing training length can be exponentially more efficient than increasing the sample size. Experiments support predictions of the theory.