In robot-assisted minimally invasive surgery, we introduce the Surgical Action Planning (SAP) task, which generates future action plans from visual inputs to address the absence of intraoperative predictive planning in current intelligent applications. SAP shows great potential for enhancing intraoperative guidance and automating procedures. However, it faces challenges such as understanding instrument-action relationships and tracking surgical progress. Large Language Models (LLMs) show promise in understanding surgical video content but remain underexplored for predictive decision-making in SAP, as they focus mainly on retrospective analysis. Challenges like data privacy, computational demands, and modality-specific constraints further highlight significant research gaps. To tackle these challenges, we introduce LLM-SAP, a Large Language Models-based Surgical Action Planning framework that predicts future actions and generates text responses by interpreting natural language prompts of surgical goals. The text responses potentially support surgical education, intraoperative decision-making, procedure documentation, and skill analysis. LLM-SAP integrates two novel modules: the Near-History Focus Memory Module (NHF-MM) for modeling historical states and the prompts factory for action planning. We evaluate LLM-SAP on our constructed CholecT50-SAP dataset using models like Qwen2.5 and Qwen2-VL, demonstrating its effectiveness in next-action prediction. Pre-trained LLMs are tested zero-shot, and supervised fine-tuning (SFT) with LoRA is implemented to address data privacy concerns. Our experiments show that Qwen2.5-72B-SFT surpasses Qwen2.5-72B with a 19.3% higher accuracy.

Large vision-language models (LVLMs) have shown great promise in medical applications, particularly in visual question answering (MedVQA) and diagnosis from medical images. However, existing datasets and models often fail to consider critical aspects of medical diagnostics, such as the integration of historical records and the analysis of disease progression over time. In this paper, we introduce MMXU (Multimodal and MultiX-ray Understanding), a novel dataset for MedVQA that focuses on identifying changes in specific regions between two patient visits. Unlike previous datasets that primarily address single-image questions, MMXU enables multi-image questions, incorporating both current and historical patient data. We demonstrate the limitations of current LVLMs in identifying disease progression on MMXU-\textit{test}, even those that perform well on traditional benchmarks. To address this, we propose a MedRecord-Augmented Generation (MAG) approach, incorporating both global and regional historical records. Our experiments show that integrating historical records significantly enhances diagnostic accuracy by at least 20\%, bridging the gap between current LVLMs and human expert performance. Additionally, we fine-tune models with MAG on MMXU-\textit{dev}, which demonstrates notable improvements. We hope this work could illuminate the avenue of advancing the use of LVLMs in medical diagnostics by emphasizing the importance of historical context in interpreting medical images. Our dataset is released at \href{https://github.com/linjiemu/MMXU}{https://github.com/linjiemu/MMXU}.

Building upon our previous investigations of O1 replication (Part 1: Journey Learning [Qin et al., 2024] and Part 2: Distillation [Huang et al., 2024]), this work explores the potential of inference-time scaling in large language models (LLMs) for medical reasoning tasks, ranging from diagnostic decision-making to treatment planning. Through extensive experiments on medical benchmarks of varying complexity (MedQA, Medbullets, and JAMA Clinical Challenges), our investigation reveals several key insights: (1) Increasing inference time does lead to improved performance. With a modest training set of 500 samples, our model yields substantial performance improvements of 6%-11%. (2) Task complexity directly correlates with the required length of reasoning chains, confirming the necessity of extended thought processes for challenging problems. (3) The differential diagnoses generated by our model adhere to the principles of the hypothetico-deductive method, producing a list of potential conditions that may explain a patient's symptoms and systematically narrowing these possibilities by evaluating the evidence. These findings demonstrate the promising synergy between inference-time scaling and journey learning in advancing LLMs' real-world clinical reasoning capabilities.

Recent advancements in medical vision-language pre-training models have driven significant progress in zero-shot disease recognition. However, transferring image-level knowledge to pixel-level tasks, such as lesion segmentation in 3D CT scans, remains a critical challenge. Due to the complexity and variability of pathological visual characteristics, existing methods struggle to align fine-grained lesion features not encountered during training with disease-related textual representations. In this paper, we present Malenia, a novel multi-scale lesion-level mask-attribute alignment framework, specifically designed for 3D zero-shot lesion segmentation. Malenia improves the compatibility between mask representations and their associated elemental attributes, explicitly linking the visual features of unseen lesions with the extensible knowledge learned from previously seen ones. Furthermore, we design a Cross-Modal Knowledge Injection module to enhance both visual and textual features with mutually beneficial information, effectively guiding the generation of segmentation results. Comprehensive experiments across three datasets and 12 lesion categories validate the superior performance of Malenia. Codes will be publicly available.

Integrating tools into Large Language Models (LLMs) has facilitated the widespread application. Despite this, in specialized downstream task contexts, reliance solely on tools is insufficient to fully address the complexities of the real world. This particularly restricts the effective deployment of LLMs in fields such as medicine. In this paper, we focus on the downstream tasks of medical calculators, which use standardized tests to assess an individual's health status. We introduce MeNTi, a universal agent architecture for LLMs. MeNTi integrates a specialized medical toolkit and employs meta-tool and nested calling mechanisms to enhance LLM tool utilization. Specifically, it achieves flexible tool selection and nested tool calling to address practical issues faced in intricate medical scenarios, including calculator selection, slot filling, and unit conversion. To assess the capabilities of LLMs for quantitative assessment throughout the clinical process of calculator scenarios, we introduce CalcQA. This benchmark requires LLMs to use medical calculators to perform calculations and assess patient health status. CalcQA is constructed by professional physicians and includes 100 case-calculator pairs, complemented by a toolkit of 281 medical tools. The experimental results demonstrate significant performance improvements with our framework. This research paves new directions for applying LLMs in demanding scenarios of medicine.

Ensuring the general efficacy and goodness for human beings from medical large language models (LLM) before real-world deployment is crucial. However, a widely accepted and accessible evaluation process for medical LLM, especially in the Chinese context, remains to be established. In this work, we introduce "MedBench", a comprehensive, standardized, and reliable benchmarking system for Chinese medical LLM. First, MedBench assembles the currently largest evaluation dataset (300,901 questions) to cover 43 clinical specialties and performs multi-facet evaluation on medical LLM. Second, MedBench provides a standardized and fully automatic cloud-based evaluation infrastructure, with physical separations for question and ground truth. Third, MedBench implements dynamic evaluation mechanisms to prevent shortcut learning and answer remembering. Applying MedBench to popular general and medical LLMs, we observe unbiased, reproducible evaluation results largely aligning with medical professionals' perspectives. This study establishes a significant foundation for preparing the practical applications of Chinese medical LLMs. MedBench is publicly accessible at https://medbench.opencompass.org.cn.

Numerous advanced Large Language Models (LLMs) now support context lengths up to 128K, and some extend to 200K. Some benchmarks in the generic domain have also followed up on evaluating long-context capabilities. In the medical domain, tasks are distinctive due to the unique contexts and need for domain expertise, necessitating further evaluation. However, despite the frequent presence of long texts in medical scenarios, evaluation benchmarks of long-context capabilities for LLMs in this field are still rare. In this paper, we propose MedOdyssey, the first medical long-context benchmark with seven length levels ranging from 4K to 200K tokens. MedOdyssey consists of two primary components: the medical-context "needles in a haystack" task and a series of tasks specific to medical applications, together comprising 10 datasets. The first component includes challenges such as counter-intuitive reasoning and novel (unknown) facts injection to mitigate knowledge leakage and data contamination of LLMs. The second component confronts the challenge of requiring professional medical expertise. Especially, we design the ``Maximum Identical Context'' principle to improve fairness by guaranteeing that different LLMs observe as many identical contexts as possible. Our experiment evaluates advanced proprietary and open-source LLMs tailored for processing long contexts and presents detailed performance analyses. This highlights that LLMs still face challenges and need for further research in this area. Our code and data are released in the repository: \url{https://github.com/JOHNNY-fans/MedOdyssey.}

Large Language Models (LLMs) have become extremely potent instruments with exceptional capacities for comprehending and producing human-like text in a wide range of applications. However, the increasing size and complexity of LLMs present significant challenges in both training and deployment, leading to substantial computational and storage costs as well as heightened energy consumption. In this paper, we provide a review of recent advancements and research directions aimed at addressing these challenges and enhancing the efficiency of LLM-based systems. We begin by discussing algorithm-level acceleration techniques focused on optimizing LLM inference speed and resource utilization. We also explore LLM-hardware co-design strategies with a vision to improve system efficiency by tailoring hardware architectures to LLM requirements. Further, we delve into LLM-to-accelerator compilation approaches, which involve customizing hardware accelerators for efficient LLM deployment. Finally, as a case study to leverage LLMs for assisting circuit design, we examine LLM-aided design methodologies for an important task: High-Level Synthesis (HLS) functional verification, by creating a new dataset that contains a large number of buggy and bug-free codes, which can be essential for training LLMs to specialize on HLS verification and debugging. For each aspect mentioned above, we begin with a detailed background study, followed by the presentation of several novel solutions proposed to overcome specific challenges. We then outline future research directions to drive further advancements. Through these efforts, we aim to pave the way for more efficient and scalable deployment of LLMs across a diverse range of applications.

Integrating Large Language Models (LLMs) with existing Knowledge Graph (KG) databases presents a promising avenue for enhancing LLMs' efficacy and mitigating their "hallucinations". Given that most KGs reside in graph databases accessible solely through specialized query languages (e.g., Cypher), there exists a critical need to bridge the divide between LLMs and KG databases by automating the translation of natural language into Cypher queries (commonly termed the "Text2Cypher" task). Prior efforts tried to bolster LLMs' proficiency in Cypher generation through Supervised Fine-Tuning. However, these explorations are hindered by the lack of annotated datasets of Query-Cypher pairs, resulting from the labor-intensive and domain-specific nature of annotating such datasets. In this study, we propose SyntheT2C, a methodology for constructing a synthetic Query-Cypher pair dataset, comprising two distinct pipelines: (1) LLM-based prompting and (2) template-filling. SyntheT2C facilitates the generation of extensive Query-Cypher pairs with values sampled from an underlying Neo4j graph database. Subsequently, SyntheT2C is applied to two medical databases, culminating in the creation of a synthetic dataset, MedT2C. Comprehensive experiments demonstrate that the MedT2C dataset effectively enhances the performance of backbone LLMs on the Text2Cypher task. Both the SyntheT2C codebase and the MedT2C dataset will be released soon.

Large language models (LLMs) have shown impressive performance on language tasks but face challenges when deployed on resource-constrained devices due to their extensive parameters and reliance on dense multiplications, resulting in high memory demands and latency bottlenecks. Shift-and-add reparameterization offers a promising solution by replacing costly multiplications with hardware-friendly primitives in both the attention and multi-layer perceptron (MLP) layers of an LLM. However, current reparameterization techniques require training from scratch or full parameter fine-tuning to restore accuracy, which is resource-intensive for LLMs. To address this, we propose accelerating pretrained LLMs through post-training shift-and-add reparameterization, creating efficient multiplication-free models, dubbed ShiftAddLLM. Specifically, we quantize each weight matrix into binary matrices paired with group-wise scaling factors. The associated multiplications are reparameterized into (1) shifts between activations and scaling factors and (2) queries and adds according to the binary matrices. To reduce accuracy loss, we present a multi-objective optimization method to minimize both weight and output activation reparameterization errors. Additionally, based on varying sensitivity across layers to reparameterization, we develop an automated bit allocation strategy to further reduce memory usage and latency. Experiments on five LLM families and eight tasks consistently validate the effectiveness of ShiftAddLLM, achieving average perplexity improvements of 5.6 and 22.7 points at comparable or lower latency compared to the most competitive quantized LLMs at 3 and 2 bits, respectively, and more than 80% memory and energy reductions over the original LLMs. Codes and models are available at https://github.com/GATECH-EIC/ShiftAddLLM.