Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAI's o1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical reasoning system, MedS3, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct rule-verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the process reward model (PRM). During inference, the policy model generates multiple responses, and the reward model selects the one with a newly proposed PRM-guided Vote-Sum (P-VS) strategy. Experiments on eleven evaluation datasets demonstrate that MedS3 outperforms not only the prior strongest medical model by 6.59, but also 32B-level general reasoning models by 8.71 points. Code and data are available at https://github.com/pixas/MedSSS.

Large language models (LLMs) hold promise for addressing healthcare challenges but often generate hallucinations due to limited integration of medical knowledge. Incorporating external medical knowledge is therefore critical, especially considering the breadth and complexity of medical content, which necessitates effective multi-source knowledge acquisition. We address this challenge by framing it as a source planning problem, where the task is to formulate context-appropriate queries tailored to the attributes of diverse knowledge sources. Existing approaches either overlook source planning or fail to achieve it effectively due to misalignment between the model's expectation of the sources and their actual content. To bridge this gap, we present MedOmniKB, a comprehensive repository comprising multigenre and multi-structured medical knowledge sources. Leveraging these sources, we propose the Source Planning Optimisation (SPO) method, which enhances multi-source utilisation through explicit planning optimisation. Our approach involves enabling an expert model to explore and evaluate potential plans while training a smaller model to learn source alignment using positive and negative planning samples. Experimental results demonstrate that our method substantially improves multi-source planning performance, enabling the optimised small model to achieve state-of-the-art results in leveraging diverse medical knowledge sources.

Large Language Models (LLMs) have shown promising potential in the medical domain, assisting with tasks like clinical note generation and patient communication. However, current LLMs are limited to text-based communication, hindering their ability to interact with diverse forms of information in clinical environments. Despite clinical agents succeeding in diverse signal interaction, they are oriented to a single clinical scenario and hence fail for broader applications. To evaluate clinical agents holistically, we propose ClinicalAgent Bench~(CAB), a comprehensive medical agent benchmark consisting of 18 tasks across five key realistic clinical dimensions. Building on this, we introduce ReflecTool, a novel framework that excels at utilizing domain-specific tools within two stages. The first optimization stage progressively enlarges a long-term memory by saving successful solving processes and tool-wise experience of agents in a tiny pre-defined training set. In the following inference stage, ReflecTool can search for supportive successful demonstrations from already built long-term memory to guide the tool selection strategy, and a verifier improves the tool usage according to the tool-wise experience with two verification methods--iterative refinement and candidate selection. Extensive experiments on ClinicalAgent Benchmark demonstrate that ReflecTool surpasses the pure LLMs with more than 10 points and the well-established agent-based methods with 3 points, highlighting its adaptability and effectiveness in solving complex clinical tasks.

Recently the retrieval-augmented generation (RAG) has been successfully applied in code generation. However, existing pipelines for retrieval-augmented code generation (RACG) employ static knowledge bases with a single source, limiting the adaptation capabilities of Large Language Models (LLMs) to domains they have insufficient knowledge of. In this work, we develop a novel pipeline, EVOR, that employs the synchronous evolution of both queries and diverse knowledge bases. On two realistic settings where the external knowledge is required to solve code generation tasks, we compile four new datasets associated with frequently updated libraries and long-tail programming languages, named EVOR-BENCH. Extensive experiments demonstrate that EVOR achieves two to four times of execution accuracy compared to other methods such as Reflexion (Shinn et al., 2024), DocPrompting (Zhou et al., 2023), etc. We demonstrate that EVOR is flexible and can be easily combined with them to achieve further improvement. Further analysis reveals that EVOR benefits from the synchronous evolution of queries and documents and the diverse information sources in the knowledge base. We hope that our studies will inspire more insights into the design of advanced RACG pipelines in future research. Our model, code, and data are available at https://arks-codegen.github.io.

Large language models (LLMs) have shown substantial progress in natural language understanding and generation, proving valuable especially in the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks, which can be categorized as knowledge-intensive tasks and alignment-required tasks. Previous approaches either ignore the latter task or focus on a minority of tasks and hence lose generalization. To address these drawbacks, we propose a progressive fine-tuning pipeline. This pipeline employs a Knowledge Aggregator and a Noise aggregator to encode diverse knowledge in the first stage and filter out detrimental information. In the second stage, we drop the Noise Aggregator to avoid the interference of suboptimal representation and leverage an additional alignment module optimized towards an orthogonal direction to the knowledge space to mitigate knowledge forgetting. Based on this two-stage paradigm, we proposed a Medical LLM through decoupling Clinical Alignment and Knowledge Aggregation (MedCare), which is designed to achieve state-of-the-art (SOTA) performance on over 20 medical tasks, as well as SOTA results on specific medical alignment tasks. Various model sizes of MedCare (1.8B, 7B, 14B) all demonstrate significant improvements over existing models with similar model sizes.

Fine-tuning on task-specific question-answer pairs is a predominant method for enhancing the performance of instruction-tuned large language models (LLMs) on downstream tasks. However, in certain specialized domains, such as healthcare or harmless content generation, it is nearly impossible to obtain a large volume of high-quality data that matches the downstream distribution. To improve the performance of LLMs in data-scarce domains with domain-mismatched data, we re-evaluated the Transformer architecture and discovered that not all parameter updates during fine-tuning contribute positively to downstream performance. Our analysis reveals that within the self-attention and feed-forward networks, only the fine-tuned attention parameters are particularly beneficial when the training set's distribution does not fully align with the test set. Based on this insight, we propose an effective inference-time intervention method: Training All parameters but Inferring with only Attention (\trainallInfAttn). We empirically validate \trainallInfAttn using two general instruction-tuning datasets and evaluate it on seven downstream tasks involving math, reasoning, and knowledge understanding across LLMs of different parameter sizes and fine-tuning techniques. Our comprehensive experiments demonstrate that \trainallInfAttn achieves superior improvements compared to both the fully fine-tuned model and the base model in most scenarios, with significant performance gains. The high tolerance of \trainallInfAttn to data mismatches makes it resistant to jailbreaking tuning and enhances specialized tasks using general data.

Fraud detection remains a challenging task due to the complex and deceptive nature of fraudulent activities. Current approaches primarily concentrate on learning only one perspective of the graph: either the topological structure of the graph or the attributes of individual nodes. However, we conduct empirical studies to reveal that these two types of features, while nearly orthogonal, are each independently effective. As a result, previous methods can not fully capture the comprehensive characteristics of the fraud graph. To address this dilemma, we present a novel framework called Relation-Aware GNN with transFormer~(RAGFormer) which simultaneously embeds both semantic and topological features into a target node. The simple yet effective network consists of a semantic encoder, a topology encoder, and an attention fusion module. The semantic encoder utilizes Transformer to learn semantic features and node interactions across different relations. We introduce Relation-Aware GNN as the topology encoder to learn topological features and node interactions within each relation. These two complementary features are interleaved through an attention fusion module to support prediction by both orthogonal features. Extensive experiments on two popular public datasets demonstrate that RAGFormer achieves state-of-the-art performance. The significant improvement of RAGFormer in an industrial credit card fraud detection dataset further validates the applicability of our method in real-world business scenarios.

Large language models like ChatGPT have shown substantial progress in natural language understanding and generation, proving valuable across various disciplines, including the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks which often require multi-task learning capabilities. Previous approaches, although beneficial, fall short in real-world applications because they necessitate task-specific annotations at inference time, limiting broader generalization. This paper introduces MING-MOE, a novel Mixture-of-Expert~(MOE)-based medical large language model designed to manage diverse and complex medical tasks without requiring task-specific annotations, thus enhancing its usability across extensive datasets. MING-MOE employs a Mixture of Low-Rank Adaptation (MoLoRA) technique, allowing for efficient parameter usage by maintaining base model parameters static while adapting through a minimal set of trainable parameters. We demonstrate that MING-MOE achieves state-of-the-art (SOTA) performance on over 20 medical tasks, illustrating a significant improvement over existing models. This approach not only extends the capabilities of medical language models but also improves inference efficiency.

Efficient attentions have greatly improved the computational efficiency of Transformers. However, most existing linear attention mechanisms suffer from an \emph{efficiency degradation} problem, leading to inefficiencies in causal language modeling and hindering their application in long-range language models. This problem is more pronounced under language modeling with unbounded contexts. In this paper, we propose \textbf{L}inear \textbf{A}ttention \textbf{V}ia \textbf{O}rthogonal memory~(\shortname) to address these limitations, achieving strong performance while maintaining linear complexity. \shortname employs orthogonal decomposition to compress a context into a fixed-size orthogonal memory while effectively minimizing redundancy within the context. Given that orthogonal memory compresses global information, we further dissect the context to amplify fine-grained local information. Additionally, we embed the relative position encoding into \shortname to improve the extrapolation ability. Experimental results show that \shortname greatly improves the efficiency of the causal language model with the best extrapolation performance and outperforms other efficient baselines. Further, we endeavor to employ \shortname for unbounded language modeling and successfully scale the context length to 128K.

Autoregressive~(AR) generation almost dominates sequence generation for its efficacy. Recently, non-autoregressive~(NAR) generation gains increasing popularity for its efficiency and growing efficacy. However, its efficiency is still bottlenecked by quadratic complexity in sequence lengths, which is prohibitive for scaling to long sequence generation and few works have been done to mitigate this problem. In this paper, we propose a novel MLP variant, \textbf{A}ttentive \textbf{M}ulti-\textbf{L}ayer \textbf{P}erceptron~(AMLP), to produce a generation model with linear time and space complexity. Different from classic MLP with static and learnable projection matrices, AMLP leverages adaptive projections computed from inputs in an attentive mode. The sample-aware adaptive projections enable communications among tokens in a sequence, and model the measurement between the query and key space. Furthermore, we marry AMLP with popular NAR models, deriving a highly efficient NAR-AMLP architecture with linear time and space complexity. Empirical results show that such marriage architecture surpasses competitive efficient NAR models, by a significant margin on text-to-speech synthesis and machine translation. We also test AMLP's self- and cross-attention ability separately with extensive ablation experiments, and find them comparable or even superior to the other efficient models. The efficiency analysis further shows that AMLP extremely reduces the memory cost against vanilla non-autoregressive models for long sequences.