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Computer Vision · Vision Models & Multimodal

Ye Sun, Hao Zhang, Henghui Ding, Tiehua Zhang, Xingjun Ma, Yu-Gang Jiang

Achieving fine-grained spatio-temporal understanding in videos remains a major challenge for current Video Large Multimodal Models (Video LMMs). Addressing this challenge requires mastering two core capabilities: video referring understanding, which captures the semantics of video regions, and video grounding, which segments object regions based on natural language descriptions. However, most existing approaches tackle these tasks in isolation, limiting progress toward unified, referentially grounded video interaction. We identify a key bottleneck in the lack of high-quality, unified video instruction data and a comprehensive benchmark for evaluating referentially grounded video chat. To address these challenges, we contribute in three core aspects: dataset, model, and benchmark. First, we introduce SAMA-239K, a large-scale dataset comprising 15K videos specifically curated to enable joint learning of video referring understanding, grounding, and multi-turn video chat. Second, we propose the SAMA model, which incorporates a versatile spatio-temporal context aggregator and a Segment Anything Model to jointly enhance fine-grained video comprehension and precise grounding capabilities. Finally, we establish SAMA-Bench, a meticulously designed benchmark consisting of 5,067 questions from 522 videos, to comprehensively evaluate the integrated capabilities of Video LMMs in multi-turn, spatio-temporal referring understanding and grounded dialogue. Extensive experiments and benchmarking results show that SAMA not only achieves strong performance on SAMA-Bench but also sets a new state-of-the-art on general grounding benchmarks, while maintaining highly competitive performance on standard visual understanding benchmarks.

Reinforcement Learning · Deep RL

Joey Hong, Anca Dragan, Sergey Levine

Large language models (LLMs) excel in tasks like question answering and dialogue, but complex tasks requiring interaction, such as negotiation and persuasion, require additional long-horizon reasoning and planning. Reinforcement learning (RL) fine-tuning can enable such planning in principle, but suffers from drawbacks that hinder scalability. In particular, multi-turn RL training incurs high memory and computational costs, which are exacerbated when training LLMs as policies. Furthermore, the largest LLMs do not expose the APIs necessary to be trained in such manner. As a result, modern methods to improve the reasoning of LLMs rely on sophisticated prompting mechanisms rather than RL fine-tuning. To remedy this, we propose a novel approach that uses goal-conditioned value functions to guide the reasoning of LLM agents, that scales even to large API-based models. These value functions predict how a task will unfold given an action, allowing the LLM agent to evaluate multiple possible outcomes, both positive and negative, to plan effectively. In addition, these value functions are trained over reasoning steps rather than full actions, to be a concise and light-weight module that facilitates decision-making in multi-turn interactions. We validate our method on tasks requiring interaction, including tool use, social deduction, and dialogue, demonstrating superior performance over both RL fine-tuning and prompting methods while maintaining efficiency and scalability.

Deep Learning · Everything Else

Xihang Qiu, Jiarong Cheng, Yuhao Fang, Wanpeng Zhang, Yao Lu, Ye Zhang, Chun Li

Multimodal Emotion Recognition in Conversations (MERC) enhances emotional understanding through the fusion of multimodal signals. However, unpredictable modality absence in real-world scenarios significantly degrades the performance of existing methods. Conventional missing-modality recovery approaches, which depend on training with complete multimodal data, often suffer from semantic distortion under extreme data distributions, such as fixed-modality absence. To address this, we propose the Federated Dialogue-guided and Semantic-Consistent Diffusion (FedDISC) framework, pioneering the integration of federated learning into missing-modality recovery. By federated aggregation of modality-specific diffusion models trained on clients and broadcasting them to clients missing corresponding modalities, FedDISC overcomes single-client reliance on modality completeness. Additionally, the DISC-Diffusion module ensures consistency in context, speaker identity, and semantics between recovered and available modalities, using a Dialogue Graph Network to capture conversational dependencies and a Semantic Conditioning Network to enforce semantic alignment. We further introduce a novel Alternating Frozen Aggregation strategy, which cyclically freezes recovery and classifier modules to facilitate collaborative optimization. Extensive experiments on the IEMOCAP, CMUMOSI, and CMUMOSEI datasets demonstrate that FedDISC achieves superior emotion classification performance across diverse missing modality patterns, outperforming existing approaches.

Applications · Language, Speech and Dialog

Benjamin Matthias Ruppik, Julius von Rohrscheidt, Carel van Niekerk, Michael Heck, Renato Vukovic, Shutong Feng, Hsien-chin Lin, Nurul Lubis, Bastian Rieck, Marcus Zibrowius 等

Understanding the internal mechanisms of large language models (LLMs) remains a challenging and complex endeavor. Even fundamental questions, such as how fine-tuning affects model behavior, often require extensive empirical evaluation. In this paper, we introduce a novel perspective based on the geometric properties of contextual latent embeddings to study the effects of training and fine-tuning. To that end, we measure the local dimensions of a contextual language model's latent space and analyze their shifts during training and fine-tuning. We show that the local dimensions provide insights into the model's training dynamics and generalization ability. Specifically, the mean of the local dimensions predicts when the model’s training capabilities are exhausted, as exemplified in a dialogue state tracking task, overfitting, as demonstrated in an emotion recognition task, and grokking, as illustrated with an arithmetic task. Furthermore, our experiments suggest a practical heuristic: reductions in the mean local dimension tend to accompany and predict subsequent performance gains. Through this exploration, we aim to provide practitioners with a deeper understanding of the implications of fine-tuning on embedding spaces, facilitating informed decisions when configuring models for specific applications. The results of this work contribute to the ongoing discourse on the interpretability, adaptability, and generalizability of LLMs by bridging the gap between intrinsic model mechanisms and geometric properties in the respective embeddings.

Applications · Language, Speech and Dialog

Jie Shao, Jianxin Wu

Despite the impressive performance of large language models (LLMs), the process of endowing them with new capabilities---such as mathematical reasoning---remains largely empirical and opaque. A critical open question is whether reasoning abilities stem from the entire model, specific modules, or are merely artifacts of overfitting. In this work, we hypothesize that the reasoning capabilities in well-trained LLMs are primarily attributed to the output projection module (o_proj) in the Transformer’s multi-head self-attention (MHSA) module. To support this hypothesis, we introduce Stethoscope for Networks (SfN), a suite of diagnostic tools designed to probe and analyze the internal behaviors of LLMs. Using SfN, we provide both circumstantial and empirical evidence suggesting that o_proj plays a central role in enabling reasoning, whereas other modules contribute more to fluent dialogue. These findings offer a new perspective on LLM interpretability and open avenues for more targeted training strategies, potentially enabling more efficient and specialized LLMs.

Social Aspects · Trustworthy Machine Learning

Mengjie Wu, Yihao Huang, Zhenjun Lin, Kangjie Chen, Yuyang zhang, Yuhan Huang, Run Wang, Lina Wang

Large language models (LLMs) are inherently designed to support multi-turn interactions, which opens up new possibilities for jailbreak attacks that unfold gradually and potentially bypass safety mechanisms more effectively than single-turn attacks. However, current multi-turn jailbreak methods are still in their early stages and suffer from two key limitations. First, they all inherently require inserting sensitive phrases into the context, which makes the dialogue appear suspicious and increases the likelihood of rejection, undermining the effectiveness of the attack. Second, even when harmful content is generated, the response often fails to align with the malicious prompt due to semantic drift, where the conversation slowly moves away from its intended goal. To address these challenges, we propose an analogy-based black-box multi-turn jailbreak framework that constructs fully benign contexts to improve attack success rate while ensuring semantic alignment with the malicious intent. The method first guides the model through safe tasks that mirror the response structure of the malicious prompt, enabling it to internalize the format without exposure to sensitive content. A controlled semantic shift is then introduced in the final turn, substituting benign elements with malicious ones while preserving structural coherence. Experiments on six commercial and open-source LLMs, two benchmark datasets show that our method significantly improves attack performance, achieving an average attack success rate of 93.3\% and outperforming five competitive baselines. Our code is released at https://anonymous.4open.science/r/AMA-E1C4

Applications

Xiaoquan Yi, Haozhao Wang, Yining Qi, Wenchao Xu, Rui Zhang, Yuhua Li, Ruixuan Li

With the increasing sophistication of Large Language Models (LLMs), it is crucial to develop reliable methods to accurately identify whether an interlocutor in real-time dialogue is human or chatbot. However, existing detection methods are primarily designed for analyzing full documents, not the unique dynamics and characteristics of dialogue. These approaches frequently overlook the nuances of interaction that are essential in conversational contexts. This work identifies two key patterns in dialogues: (1) Human-Human (H-H) interactions exhibit significant bidirectional sentiment influence, while (2) Human-Chatbot (H-C) interactions display a clear asymmetric pattern. We propose an innovative approach named ChatbotID, which applies the Granger Causality Test (GCT) to extract a novel set of interactional features that capture the evolving, predictive relationships between conversational attributes. By synergistically fusing these GCT-based interactional features with contextual embeddings, and optimizing the model through a meticulous loss function. Experimental results across multiple datasets and detection models demonstrate the effectiveness of our framework, with significant improvements in accuracy for distinguishing between H-H and H-C dialogues.

Computer Vision · Vision Models & Multimodal

Hsin Yi Hsieh, Shang-Wei Liu, Chang-Chih Meng, Chien-Hua Chen, Shuo-Yueh Lin, Hung-Ju Lin, Hen-Hsen Huang, I-Chen Wu

Vision-language models (VLMs) often struggle with culturally specific content — a challenge largely overlooked by existing benchmarks that focus on dominant languages and globalized datasets. We introduce TᴀɪᴡᴀɴVQA, a VQA benchmark designed for Taiwanese culture to evaluate recognition and reasoning in regional contexts. TᴀɪᴡᴀɴVQA contains 2,736 images and 5,472 manually curated questions covering topics such as traditional foods, public signs, festivals, and landmarks. The official benchmark set includes 1,000 images and 2,000 questions for systematic assessment, with the remainder of the data used as training material. Evaluations on state-of-the-art VLMs reveal strong visual recognition but notable weaknesses in cultural reasoning. To address this, we propose a data augmentation strategy that combines human-annotated and synthesized dialogues to enhance cultural understanding. Fine-tuning yields significant gains on TᴀɪᴡᴀɴVQA while maintaining stable performance on other multimodal tasks. To further explore the models’ cultural understanding, we conducted an open-ended question answering experiment. The results indicate a notable decline in cultural knowledge generation ($\approx$10–20\%), suggesting challenges remain. TᴀɪᴡᴀɴVQA offers a scalable framework for building culturally grounded AI models in low-resource cultures, promoting diversity and fairness in multimodal AI. Our dataset and code are publicly available on [Hugging Face](https://huggingface.co/datasets/hhhuang/TaiwanVQA) and [GitHub](https://github.com/hhhuang/TaiwanVQA).

Applications · Everything Else

Aruna Gauba, Irene Pi, Yunze Man, Ziqi Pang, Vikram Adve, Yu-Xiong Wang

We present **AgMMU**, a challenging real‑world benchmark for evaluating and advancing vision-language models (VLMs) in the knowledge‑intensive domain of agriculture. Unlike prior datasets that rely on crowdsourced prompts, AgMMU is distilled from 116,231 authentic dialogues between everyday growers and USDA-authorized Cooperative Extension experts. Through a three‑stage pipeline: automated knowledge extraction, QA generation, and human verification, we construct (i) AgMMU, an evaluation set of 746 multiple‑choice questions (MCQs) and 746 open‑ended questions (OEQs), and (ii) AgBase, a development corpus of 57,079 multimodal facts covering five high-stakes agricultural topics: insect identification, species identification, disease categorization, symptom description, and management instruction. AgMMU has three key advantages:- **Authentic \& Expert‑Verified**: All facts, images, and answers originate from real farmer and gardener inquiries answered by credentialed specialists, ensuring high‑fidelity agricultural knowledge.- **Complete Development Suite**: AgMMU uniquely couples a dual‑format evaluation benchmark (MCQ and OEQ) with AgBase, a large‑scale training set, enabling both rigorous assessment and targeted improvement of VLMs.- **Knowledge‑intensive Challenge**: Our tasks demand the synergy of nuanced visual perception and domain expertise, exposing fundamental limitations of current general‑purpose models and charting a path toward robust, application‑ready agricultural AI.Benchmarking 12 leading VLMs reveals pronounced gaps in fine‑grained perception and factual grounding. Open‑sourced models trail after proprietary ones by a wide margin. Simple fine‑tuning on AgBase boosts open-sourced model performance on challenging OEQs for up to 11.6\% on average, narrowing this gap and also motivating future research to propose better strategies in knowledge extraction and distillation from AgBase. We hope AgMMU stimulates research on domain‑specific knowledge integration and trustworthy decision support in agriculture AI development.

Computer Vision · Vision Models & Multimodal

Vardhan Dongre, Chi Gui, Shubham Garg, Hooshang Nayyeri, Gokhan Tur, Dilek Hakkani-Tur, Vikram Adve

We introduce MIRAGE, a new benchmark for multimodal expert-level reasoning and decision-making in consultative interaction settings. Designed for the domain of agriculture, MIRAGE captures the full complexity of expert consultations by combining natural user queries, expert-authored responses, and image-based context, offering a high-fidelity benchmark for evaluating models on grounded reasoning, clarification strategies, and long-form generation in a real-world, knowledge-intensive domain. Grounded in over 35,000 real user-expert interactions, and curated through a carefully designed multi-step pipeline, MIRAGE spans diverse crop health, pest diagnosis, and crop management scenarios. The benchmark includes more than 7,000 unique biological entities, covering plant species, pests, and diseases, making it one of the most taxonomically diverse benchmarks available for vision-language models in real-world expert-guided domains. Unlike existing benchmarks that rely on well-specified user inputs, MIRAGE features underspecified, context-rich scenarios, requiring models to infer latent knowledge gaps and either proactively guide the interaction or respond. Our benchmark comprises two core components. The Single-turn Challenge to reason over a single user turn and image set, identify relevant entities, infer causal explanations, and generate actionable recommendations; and a Multi-Turn challenge for dialogue state tracking, goal-driven generation, and expert-level conversational decision-making. We evaluate more than 20 closed and open-source frontier vision-language models (VLMs), using three reasoning language models as evaluators, highlighting the significant challenges posed by MIRAGE in both single-turn and multi-turn interaction settings. Even the advanced GPT4.1 and GPT4o models achieve 44.6% and 40.9% accuracy, respectively, indicating significant room for improvement.

Applications · Health

Daeun Kyung, Hyunseung Chung, Seongsu Bae, Jiho Kim, Jae Ho Sohn, Taerim Kim, Soo Kyung Kim, Edward Choi

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations.We evaluate eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3 70B, is validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare. The code is available at https://github.com/dek924/PatientSim.

Social Aspects

Alexandra Olteanu, Su Lin Blodgett, Agathe Balayn, Angelina Wang, Fernando Diaz, Flavio Calmon, Margaret Mitchell, Michael Ekstrand, Reuben Binns, Solon Barocas

In AI research and practice, rigor remains largely understood in terms of methodological rigor---such as whether mathematical, statistical, or computational methods are correctly applied. We argue that this narrow conception of rigor has contributed to the concerns raised by the responsible AI community, including overblown claims about the capabilities of AI systems. Our position is that a broader conception of what rigorous AI research and practice should entail is needed. We believe such a conception---in addition to a more expansive understanding of 1) methodological rigor---should include aspects related to 2) what background knowledge informs what to work on (epistemic rigor); 3) how disciplinary, community, or personal norms, standards, or beliefs influence the work (normative rigor); 4) how clearly articulated the theoretical constructs under use are (conceptual rigor); 5) what is reported and how (reporting rigor); and 6) how well-supported the inferences from existing evidence are (interpretative rigor). In doing so, we also provide useful language and a framework for much needed dialogue about the AI community's work by researchers, policymakers, journalists, and other stakeholders.

Deep Learning · Generative Models and Autoencoders

Shen Nie, Fengqi Zhu, Zebin You, Xiaolu Zhang, Jingyang Ou, Jun Hu, Jun Zhou, Yankai Lin, Ji-Rong Wen, Chongxuan LI

The capabilities of large language models (LLMs) are widely regarded as relying on autoregressive models (ARMs). We challenge this notion by introducing *LLaDA*, a diffusion model trained from scratch under the pre-training and supervised fine-tuning (SFT) paradigm. LLaDA employs a forward data masking process and a reverse generation process, parameterized by a Transformer to predict masked tokens. It provides a principled generative approach for probabilistic inference by optimizing a likelihood lower bound. Across extensive benchmarks on general tasks, math, code, and so on, LLaDA demonstrates strong *scalability* and performs comparably to our self-constructed ARM baselines. Remarkably, LLaDA 8B is competitive with strong LLMs like LLaMA3 8B in *in-context learning* and, after SFT, exhibits impressive *instruction-following* abilities in case studies such as multi-turn dialogue. Moreover, LLaDA addresses the reversal curse, surpassing GPT-4o in a reversal poem completion task. Our findings show the promise of diffusion models for language modeling at scale and challenge the common assumption that core LLM capabilities discussed above inherently depend on ARMs. Project page and codes: \url{https://ml-gsai.github.io/LLaDA-demo/}.

Fengxiang Wang, Mingshuo Chen, Yueying Li, Di Wang, Haotian Wang, Zonghao Guo, Zefan Wang, Shan Boqi, Long Lan, Yulin Wang 等

Ultra-high-resolution (UHR) remote sensing (RS) imagery offers valuable data for Earth observation but pose challenges for existing multimodal foundation models due to two key bottlenecks: (1) limited availability of UHR training data, and (2) token explosion caused by the large image size. To address data scarcity, we introduce **SuperRS-VQA** (avg. 8,376$\times$8,376) and **HighRS-VQA** (avg. 2,000$\times$1,912), the highest-resolution vision-language datasets in RS to date, covering 22 real-world dialogue tasks. To mitigate token explosion, our pilot studies reveal significant redundancy in RS images: crucial information is concentrated in a small subset of object-centric tokens, while pruning background tokens (e.g., ocean or forest) can even improve performance. Motivated by these findings, we propose two strategies: *Background Token Pruning* and *Anchored Token Selection*, to reduce the memory footprint while preserving key semantics. Integrating these techniques, we introduce **GeoLLaVA-8K**, the first RS-focused multimodal large language model capable of handling inputs up to 8K$\times$8K resolution, built on the LLaVA framework. Trained on SuperRS-VQA and HighRS-VQA, GeoLLaVA-8K sets a new state-of-the-art on the XLRS-Bench. Datasets and code were released at https://github.com/MiliLab/GeoLLaVA-8K.

Applications · Language, Speech and Dialog

Weixiang Zhao, Xingyu Sui, Yulin Hu, Jiahe Guo, Haixiao Liu, Biye Li, Yanyan Zhao, Bing Qin, Ting Liu

Personalized alignment is essential for enabling large language models (LLMs) to engage effectively in user-centric dialogue. While recent prompt-based and offline optimization methods offer preliminary solutions, they fall short in cold-start scenarios and long-term personalization due to their inherently static and shallow designs. In this work, we introduce the Reinforcement Learning for Personalized Alignment (RLPA) framework, in which an LLM interacts with a simulated user model to iteratively infer and refine user profiles through dialogue. The training process is guided by a dual-level reward structure: the Profile Reward encourages accurate construction of user representations, while the Response Reward incentivizes generation of responses consistent with the inferred profile. We instantiate RLPA by fine-tuning Qwen-2.5-3B-Instruct, resulting in Qwen-RLPA, which achieves state-of-the-art performance in personalized dialogue. Empirical evaluations demonstrate that Qwen-RLPA consistently outperforms prompting and offline fine-tuning baselines, and even surpasses advanced commercial models such as Claude-3.5 and GPT-4o. Further analysis highlights Qwen-RLPA's robustness in reconciling conflicting user preferences, sustaining long-term personalization and delivering more efficient inference compared to recent reasoning-focused LLMs. These results emphasize the potential of dynamic profile inference as a more effective paradigm for building personalized dialogue systems.

Kyochul Jang, Donghyeon Lee, Kyusik Kim, Dongseok Heo, Taewhoo Lee, Woojeong Kim, Bongwon Suh

Existing function-calling benchmarks focus on single-turn interactions. However, they overlook the complexity of real-world scenarios. To quantify how existing benchmarks address practical applications, we introduce DICE-SCORE, a metric that evaluates the dispersion of tool-related information such as function name and parameter values throughout the dialogue. Analyzing existing benchmarks through DICE-SCORE reveals notably low scores, highlighting the need for more realistic scenarios. To address this gap, we present DICE-BENCH, a framework that constructs practical function-calling datasets by synthesizing conversations through a tool graph that maintains dependencies across rounds and a multi-agent system with distinct personas to enhance dialogue naturalness. The final dataset comprises 1,607 high-DICE-SCORE instances. Our experiments on 19 LLMs with DICE-BENCH show that significant advances are still required before such models can be deployed effectively in real-world settings. Our code and data are all publicly available.

Xinjie Zhang, Wenxuan Wang, Qin Jin

In emotional support conversations, unclear intentions can lead supporters to employ inappropriate strategies, inadvertently imposing their expectations or solutions on the seeker. Clearly defined intentions are essential for guiding both the supporter’s motivations and the overall emotional support process. In this paper, we propose the Intention-centered Emotional Support Conversation (IntentionESC) framework, which defines the possible intentions of supporters in emotional support conversations, identifies key emotional state aspects for inferring these intentions, and maps them to appropriate support strategies. While Large Language Models (LLMs) excel in text generating, they fundamentally operate as probabilistic models trained on extensive datasets, lacking a true understanding of human thought processes and intentions. To address this limitation, we introduce the Intention CEntric Chain-of-Thought (ICECoT) mechanism. ICECoT enables LLMs to mimic human reasoning by analyzing emotional states, inferring intentions, and selecting suitable support strategies, thereby generating more effective emotional support responses. To train the model with ICECoT and integrate expert knowledge, we design an automated annotation pipeline that produces high-quality training data. Furthermore, we develop a comprehensive evaluation scheme to assess emotional support efficacy and conduct extensive experiments to validate our framework. Our data and code will be publically released to facilitate further research.

Ke Ji, Yixin Lian, Linxu Li, Jingsheng Gao, Weiyuan Li, Bin Dai

In recent years, large language models (LLMs) have achieved breakthrough progress in many dialogue generation tasks. However, their lack of emotion and fine-grained role awareness limits the model’s ability to provide personalized and diverse interactions further. Current methods face high costs in collecting high-quality annotated data for scenarios such as role-playing, and traditional human alignment methods are difficult to deploy due to the inherent diversity of model behavior in role-playing scenarios. Inspired by the alignment of models for safety behaviors through RLHF (Reinforcement Learning from Human Feedback), in this paper, we revisit model role-playing behavior from the perspective of persona alignment and propose a novel annotation-free framework named Persona-Aware Contrastive Learning (PCL) to align LLMs’ behavior during role-playing, enhancing the model’s role consistency. Specifically, we first design a role chain method to encourage the model to self-question based on the role characteristics and dialogue context to adjust personality consistency. Then, we further enhance the model’s role-playing strategy through iterative adversarial modeling between the use of role characteristics and not. Experiments on both black-box and white-box LLMs show that LLMs equipped with PCL significantly outperform vanilla LLMs under automatic evaluation methods (CharEval & GPT-4) and human expert evaluation.

Hongda Sun, Jiaren Peng, Wenzhong Yang, Liang He, Bo Du, Rui Yan

Medical dialogue systems (MDS) have emerged as crucial online platforms for enabling multi-turn, context-aware conversations with patients. However, existing MDS often struggle to (1) identify relevant medical knowledge and (2) generate personalized, medically accurate responses. To address these challenges, we propose MedRef, a novel MDS that incorporates knowledge refining and dynamic prompt adjustment. First, we employ a knowledge refining mechanism to filter out irrelevant medical data, improving predictions of critical medical entities in responses. Additionally, we design a comprehensive prompt structure that incorporates historical details and evident details. To enable real-time adaptability to diverse patient conditions, we implement two key modules, Triplet Filter and Demo Selector, providing appropriate knowledge and demonstrations equipped in the system prompt.Extensive experiments on MedDG and KaMed benchmarks show that MedRef outperforms state-of-the-art baselines in both generation quality and medical entity accuracy, underscoring its effectiveness and reliability for real-world healthcare applications.

Weijieying Ren, Tianxiang Zhao, Lei Wang, Tianchun Wang, Vasant G Honavar

Recent advances in Large Language Models (LLMs) have led to remarkable progresses in medical consultation.However, existing medical LLMs overlook the essential role of Electronic Health Records (EHR) and focus primarily on diagnosis recommendation, limiting their clinical applicability. We propose DiaLLM, the first medical LLM that integrates heterogeneous EHR data into clinically grounded dialogues, enabling clinical test recommendation, result interpretation, and diagnosis prediction to better align with real-world medical practice. To construct clinically grounded dialogues from EHR, we design a Clinical Test Reference (CTR) strategy that maps each clinical code to its corresponding description and classifies test results as “normal” or “abnormal”. Additionally, DiaLLM employs a reinforcement learning framework for evidence acquisition and automated diagnosis. To handle the large action space, we introduce a reject sampling strategy to reduce redundancy and improve exploration efficiency. Furthermore, a confirmation reward and a class-sensitive diagnosis reward are designed to guide accurate diagnosis prediction.Extensive experimental results demonstrate that DiaLLM outperforms baselines in clinical test recommendation and diagnosis prediction. Our code is available at Github.