We consider the problem of quantifying how an input perturbation impacts the outputs of large language models (LLMs), a fundamental task for model reliability and post-hoc interpretability. A key obstacle in this domain is disentangling the meaningful changes in model responses from the intrinsic stochasticity of LLM outputs. To overcome this, we introduce Distribution-Based Perturbation Analysis (DBPA), a framework that reformulates LLM perturbation analysis as a frequentist hypothesis testing problem. DBPA constructs empirical null and alternative output distributions within a low-dimensional semantic similarity space via Monte Carlo sampling. Comparisons of Monte Carlo estimates in the reduced dimensionality space enables tractable frequentist inference without relying on restrictive distributional assumptions. The framework is model-agnostic, supports the evaluation of arbitrary input perturbations on any black-box LLM, yields interpretable p-values, supports multiple perturbation testing via controlled error rates, and provides scalar effect sizes for any chosen similarity or distance metric. We demonstrate the effectiveness of DBPA in evaluating perturbation impacts, showing its versatility for perturbation analysis.

The predominant de facto paradigm of testing ML models relies on either using only held-out data to compute aggregate evaluation metrics or by assessing the performance on different subgroups. However, such data-only testing methods operate under the restrictive assumption that the available empirical data is the sole input for testing ML models, disregarding valuable contextual information that could guide model testing. In this paper, we challenge the go-to approach of data-only testing and introduce context-aware testing (CAT) which uses context as an inductive bias to guide the search for meaningful model failures. We instantiate the first CAT system, SMART Testing, which employs large language models to hypothesize relevant and likely failures, which are evaluated on data using a self-falsification mechanism. Through empirical evaluations in diverse settings, we show that SMART automatically identifies more relevant and impactful failures than alternatives, demonstrating the potential of CAT as a testing paradigm.

Real-world machine learning systems often encounter model performance degradation due to distributional shifts in the underlying data generating process (DGP). Existing approaches to addressing shifts, such as concept drift adaptation, are limited by their reason-agnostic nature. By choosing from a pre-defined set of actions, such methods implicitly assume that the causes of model degradation are irrelevant to what actions should be taken, limiting their ability to select appropriate adaptations. In this paper, we propose an alternative paradigm to overcome these limitations, called self-healing machine learning (SHML). Contrary to previous approaches, SHML autonomously diagnoses the reason for degradation and proposes diagnosis-based corrective actions. We formalize SHML as an optimization problem over a space of adaptation actions to minimize the expected risk under the shifted DGP. We introduce a theoretical framework for self-healing systems and build an agentic self-healing solution H-LLM which uses large language models to perform self-diagnosis by reasoning about the structure underlying the DGP, and self-adaptation by proposing and evaluating corrective actions. Empirically, we analyze different components of H-LLM to understand why and when it works, demonstrating the potential of self-healing ML.

Digital health tools have the potential to significantly improve the delivery of healthcare services. However, their adoption remains comparatively limited due, in part, to challenges surrounding usability and trust. Recently, Large Language Models (LLMs) have emerged as general-purpose models with the ability to process complex information and produce human-quality text, presenting a wealth of potential applications in healthcare. Directly applying LLMs in clinical settings is not straightforward, with LLMs susceptible to providing inconsistent or nonsensical answers. We describe how LLM-based systems can utilize external tools to provide a novel interface between clinicians and digital technologies. This enhances the utility and practical impact of digital healthcare tools and AI models while addressing current issues with using LLM in clinical settings such as hallucinations. We illustrate LLM-based interfaces with examples from cardiovascular disease and diabetes risk prediction, highlighting the benefit compared to traditional interfaces for digital tools.