Differential diagnosis is crucial for medicine as it helps healthcare providers systematically distinguish between conditions that share similar symptoms. This study assesses the impact of lab test results on differential diagnoses (DDx) made by large language models (LLMs). Clinical vignettes from 50 case reports from PubMed Central were created incorporating patient demographics, symptoms, and lab results. Five LLMs GPT-4, GPT-3.5, Llama-2-70b, Claude-2, and Mixtral-8x7B were tested to generate Top 10, Top 5, and Top 1 DDx with and without lab data. A comprehensive evaluation involving GPT-4, a knowledge graph, and clinicians was conducted. GPT-4 performed best, achieving 55% accuracy for Top 1 diagnoses and 60% for Top 10 with lab data, with lenient accuracy up to 80%. Lab results significantly improved accuracy, with GPT-4 and Mixtral excelling, though exact match rates were low. Lab tests, including liver function, metabolic/toxicology panels, and serology/immune tests, were generally interpreted correctly by LLMs for differential diagnosis.

Retrieval-augmented generation (RAG) enhances the question-answering (QA) abilities of large language models (LLMs) by integrating external knowledge. However, adapting general-purpose RAG systems to specialized fields such as science and medicine poses unique challenges due to distribution shifts and limited access to domain-specific data. To tackle this, we propose SimRAG, a self-training approach that equips the LLM with joint capabilities of question answering and question generation for domain adaptation. Our method first fine-tunes the LLM on instruction-following, question-answering, and search-related data. Then, it prompts the same LLM to generate diverse domain-relevant questions from unlabeled corpora, with an additional filtering strategy to retain high-quality synthetic examples. By leveraging these synthetic examples, the LLM can improve their performance on domain-specific RAG tasks. Experiments on 11 datasets, spanning two backbone sizes and three domains, demonstrate that SimRAG outperforms baselines by 1.2\%--8.6\%.

Large language models (LLMs) have become integral tool for users from various backgrounds. LLMs, trained on vast corpora, reflect the linguistic and cultural nuances embedded in their pre-training data. However, the values and perspectives inherent in this data can influence the behavior of LLMs, leading to potential biases. As a result, the use of LLMs in contexts involving spiritual or moral values necessitates careful consideration of these underlying biases. Our work starts with verification of our hypothesis by testing the spiritual values of popular LLMs. Experimental results show that LLMs' spiritual values are quite diverse, as opposed to the stereotype of atheists or secularists. We then investigate how different spiritual values affect LLMs in social-fairness scenarios e.g., hate speech identification). Our findings reveal that different spiritual values indeed lead to different sensitivity to different hate target groups. Furthermore, we propose to continue pre-training LLMs on spiritual texts, and empirical results demonstrate the effectiveness of this approach in mitigating spiritual bias.

Generating high-quality, in-depth textual documents, such as academic papers, news articles, Wikipedia entries, and books, remains a significant challenge for Large Language Models (LLMs). In this paper, we propose to use planning to generate long form content. To achieve our goal, we generate intermediate steps via an auxiliary task that teaches the LLM to plan, reason and structure before generating the final text. Our main novelty lies in a single auxiliary task that does not require multiple rounds of prompting or planning. To overcome the scarcity of training data for these intermediate steps, we leverage LLMs to generate synthetic intermediate writing data such as outlines, key information and summaries from existing full articles. Our experiments demonstrate on two datasets from different domains, namely the scientific news dataset SciNews and Wikipedia datasets in KILT-Wiki and FreshWiki, that LLMs fine-tuned with the auxiliary task generate higher quality documents. We observed +2.5% improvement in ROUGE-Lsum, and a strong 3.60 overall win/loss ratio via human SxS evaluation, with clear wins in organization, relevance, and verifiability.

Recent advancements in multimodal foundation models have showcased impressive capabilities in understanding and reasoning with visual and textual information. Adapting these foundation models trained for general usage to specialized domains like biomedicine requires large-scale domain-specific instruction datasets. While existing works have explored curating such datasets automatically, the resultant datasets are not explicitly aligned with domain expertise. In this work, we propose a data-centric framework, Biomedical Visual Instruction Tuning with Clinician Preference Alignment (BioMed-VITAL), that incorporates clinician preferences into both stages of generating and selecting instruction data for tuning biomedical multimodal foundation models. First, during the generation stage, we prompt the GPT-4V generator with a diverse set of clinician-selected demonstrations for preference-aligned data candidate generation. Then, during the selection phase, we train a separate selection model, which explicitly distills clinician and policy-guided model preferences into a rating function to select high-quality data for medical instruction tuning. Results show that the model tuned with the instruction-following data from our method demonstrates a significant improvement in open visual chat (18.5% relatively) and medical VQA (win rate up to 81.73%). Our instruction-following data and models are available at BioMed-VITAL.github.io.

Pretraining plays a pivotal role in acquiring generalized knowledge from large-scale data, achieving remarkable successes as evidenced by large models in CV and NLP. However, progress in the graph domain remains limited due to fundamental challenges such as feature heterogeneity and structural heterogeneity. Recently, increasing efforts have been made to enhance node feature quality with Large Language Models (LLMs) on text-attributed graphs (TAGs), demonstrating superiority to traditional bag-of-words or word2vec techniques. These high-quality node features reduce the previously critical role of graph structure, resulting in a modest performance gap between Graph Neural Networks (GNNs) and structure-agnostic Multi-Layer Perceptrons (MLPs). Motivated by this, we introduce a feature-centric pretraining perspective by treating graph structure as a prior and leveraging the rich, unified feature space to learn refined interaction patterns that generalizes across graphs. Our framework, Graph Sequence Pretraining with Transformer (GSPT), samples node contexts through random walks and employs masked feature reconstruction to capture pairwise proximity in the LLM-unified feature space using a standard Transformer. By utilizing unified text representations rather than varying structures, our framework achieves significantly better transferability among graphs within the same domain. GSPT can be easily adapted to both node classification and link prediction, demonstrating promising empirical success on various datasets.

The growing availability of well-organized Electronic Health Records (EHR) data has enabled the development of various machine learning models towards disease risk prediction. However, existing risk prediction methods overlook the heterogeneity of complex diseases, failing to model the potential disease subtypes regarding their corresponding patient visits and clinical concept subgroups. In this work, we introduce TACCO, a novel framework that jointly discovers clusters of clinical concepts and patient visits based on a hypergraph modeling of EHR data. Specifically, we develop a novel self-supervised co-clustering framework that can be guided by the risk prediction task of specific diseases. Furthermore, we enhance the hypergraph model of EHR data with textual embeddings and enforce the alignment between the clusters of clinical concepts and patient visits through a contrastive objective. Comprehensive experiments conducted on the public MIMIC-III dataset and Emory internal CRADLE dataset over the downstream clinical tasks of phenotype classification and cardiovascular risk prediction demonstrate an average 31.25% performance improvement compared to traditional ML baselines and a 5.26% improvement on top of the vanilla hypergraph model without our co-clustering mechanism. In-depth model analysis, clustering results analysis, and clinical case studies further validate the improved utilities and insightful interpretations delivered by TACCO. Code is available at https://github.com/PericlesHat/TACCO.

The rapid advancement of large language models (LLMs) has catalyzed the deployment of LLM-powered agents across numerous applications, raising new concerns regarding their safety and trustworthiness. Existing methods for enhancing the safety of LLMs are not directly transferable to LLM-powered agents due to their diverse objectives and output modalities. In this paper, we propose GuardAgent, the first LLM agent as a guardrail to other LLM agents. Specifically, GuardAgent oversees a target LLM agent by checking whether its inputs/outputs satisfy a set of given guard requests defined by the users. GuardAgent comprises two steps: 1) creating a task plan by analyzing the provided guard requests, and 2) generating guardrail code based on the task plan and executing the code by calling APIs or using external engines. In both steps, an LLM is utilized as the core reasoning component, supplemented by in-context demonstrations retrieved from a memory module. Such knowledge-enabled reasoning allows GuardAgent to understand various textual guard requests and accurately "translate" them into executable code that provides reliable guardrails. Furthermore, GuardAgent is equipped with an extendable toolbox containing functions and APIs and requires no additional LLM training, which underscores its generalization capabilities and low operational overhead. Additionally, we propose two novel benchmarks: an EICU-AC benchmark for assessing privacy-related access control for healthcare agents and a Mind2Web-SC benchmark for safety evaluation for web agents. We show the effectiveness of GuardAgent on these two benchmarks with 98.7% and 90.0% accuracy in moderating invalid inputs and outputs for the two types of agents, respectively. We also show that GuardAgent is able to define novel functions in adaption to emergent LLM agents and guard requests, which underscores its strong generalization capabilities.

Electronic Health Records (EHRs) contain rich patient information and are crucial for clinical research and practice. In recent years, deep learning models have been applied to EHRs, but they often rely on massive features, which may not be readily available for all patients. We propose HTP-Star, which leverages hypergraph structures with a pretrain-then-finetune framework for modeling EHR data, enabling seamless integration of additional features. Additionally, we design two techniques, namely (1) Smoothness-inducing Regularization and (2) Group-balanced Reweighting, to enhance the model's robustness during fine-tuning. Through experiments conducted on two real EHR datasets, we demonstrate that HTP-Star consistently outperforms various baselines while striking a balance between patients with basic and extra features.

We present RAM-EHR, a Retrieval AugMentation pipeline to improve clinical predictions on Electronic Health Records (EHRs). RAM-EHR first collects multiple knowledge sources, converts them into text format, and uses dense retrieval to obtain information related to medical concepts. This strategy addresses the difficulties associated with complex names for the concepts. RAM-EHR then augments the local EHR predictive model co-trained with consistency regularization to capture complementary information from patient visits and summarized knowledge. Experiments on two EHR datasets show the efficacy of RAM-EHR over previous knowledge-enhanced baselines (3.4% gain in AUROC and 7.2% gain in AUPR), emphasizing the effectiveness of the summarized knowledge from RAM-EHR for clinical prediction tasks. The code will be published at \url{https://github.com/ritaranx/RAM-EHR}.