Daily Papers

The field of computational pathology has been transformed with recent advances in foundation models that encode histopathology region-of-interests (ROIs) into versatile and transferable feature representations via self-supervised learning (SSL). However, translating these advancements to address complex clinical challenges at the patient and slide level remains constrained by limited clinical data in disease-specific cohorts, especially for rare clinical conditions. We propose TITAN, a multimodal whole slide foundation model pretrained using 335,645 WSIs via visual self-supervised learning and vision-language alignment with corresponding pathology reports and 423,122 synthetic captions generated from a multimodal generative AI copilot for pathology. Without any finetuning or requiring clinical labels, TITAN can extract general-purpose slide representations and generate pathology reports that generalize to resource-limited clinical scenarios such as rare disease retrieval and cancer prognosis. We evaluate TITAN on diverse clinical tasks and find that TITAN outperforms both ROI and slide foundation models across machine learning settings such as linear probing, few-shot and zero-shot classification, rare cancer retrieval and cross-modal retrieval, and pathology report generation.

Despite the impressive capabilities of Large Language Models (LLMs) in general medical domains, questions remain about their performance in diagnosing rare diseases. To answer this question, we aim to assess the diagnostic performance of LLMs in rare diseases, and explore methods to enhance their effectiveness in this area. In this work, we introduce a rare disease question-answering (ReDis-QA) dataset to evaluate the performance of LLMs in diagnosing rare diseases. Specifically, we collected 1360 high-quality question-answer pairs within the ReDis-QA dataset, covering 205 rare diseases. Additionally, we annotated meta-data for each question, facilitating the extraction of subsets specific to any given disease and its property. Based on the ReDis-QA dataset, we benchmarked several open-source LLMs, revealing that diagnosing rare diseases remains a significant challenge for these models. To facilitate retrieval augmentation generation for rare disease diagnosis, we collect the first rare diseases corpus (ReCOP), sourced from the National Organization for Rare Disorders (NORD) database. Specifically, we split the report of each rare disease into multiple chunks, each representing a different property of the disease, including their overview, symptoms, causes, effects, related disorders, diagnosis, and standard therapies. This structure ensures that the information within each chunk aligns consistently with a question. Experiment results demonstrate that ReCOP can effectively improve the accuracy of LLMs on the ReDis-QA dataset by an average of 8%. Moreover, it significantly guides LLMs to generate trustworthy answers and explanations that can be traced back to existing literature.

This work introduces RARE (Retrieval-Augmented Reasoning Enhancement), a versatile extension to the mutual reasoning framework (rStar), aimed at enhancing reasoning accuracy and factual integrity across large language models (LLMs) for complex, knowledge-intensive tasks such as commonsense and medical reasoning. RARE incorporates two innovative actions within the Monte Carlo Tree Search (MCTS) framework: A6, which generates search queries based on the initial problem statement, performs information retrieval using those queries, and augments reasoning with the retrieved data to formulate the final answer; and A7, which leverages information retrieval specifically for generated sub-questions and re-answers these sub-questions with the relevant contextual information. Additionally, a Retrieval-Augmented Factuality Scorer is proposed to replace the original discriminator, prioritizing reasoning paths that meet high standards of factuality. Experimental results with LLaMA 3.1 show that RARE enables open-source LLMs to achieve competitive performance with top open-source models like GPT-4 and GPT-4o. This research establishes RARE as a scalable solution for improving LLMs in domains where logical coherence and factual integrity are critical.

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

We investigate whether in-context examples, widely used in decoder-only language models (LLMs), can improve embedding model performance in retrieval tasks. Unlike in LLMs, naively prepending in-context examples (query-document pairs) to the target query at inference time does not work out of the box. We introduce a simple approach to enable retrievers to use in-context examples. Our approach, RARe, finetunes a pre-trained model with in-context examples whose query is semantically similar to the target query. This can be applied to adapt various base architectures (i.e., decoder-only language models, retriever models) and consistently achieves performance gains of up to +2.72% nDCG across various open-domain retrieval datasets (BeIR, RAR-b). In particular, we find RARe exhibits stronger out-of-domain generalization compared to models using queries without in-context examples, similar to what is seen for in-context learning in LLMs. We further provide analysis on the design choices of in-context example augmentation and lay the foundation for future work in this space.

Developing advanced medical imaging retrieval systems is challenging due to the varying definitions of `similar images' across different medical contexts. This challenge is compounded by the lack of large-scale, high-quality medical imaging retrieval datasets and benchmarks. In this paper, we propose a novel methodology that leverages dense radiology reports to define image-wise similarity ordering at multiple granularities in a scalable and fully automatic manner. Using this approach, we construct two comprehensive medical imaging retrieval datasets: MIMIC-IR for Chest X-rays and CTRATE-IR for CT scans, providing detailed image-image ranking annotations conditioned on diverse anatomical structures. Furthermore, we develop two retrieval systems, RadIR-CXR and model-ChestCT, which demonstrate superior performance in traditional image-image and image-report retrieval tasks. These systems also enable flexible, effective image retrieval conditioned on specific anatomical structures described in text, achieving state-of-the-art results on 77 out of 78 metrics.

Electronic Health Record (EHR) retrieval plays a pivotal role in various clinical tasks, but its development has been severely impeded by the lack of publicly available benchmarks. In this paper, we introduce a novel public EHR retrieval benchmark, CliniQ, to address this gap. We consider two retrieval settings: Single-Patient Retrieval and Multi-Patient Retrieval, reflecting various real-world scenarios. Single-Patient Retrieval focuses on finding relevant parts within a patient note, while Multi-Patient Retrieval involves retrieving EHRs from multiple patients. We build our benchmark upon 1,000 discharge summary notes along with the ICD codes and prescription labels from MIMIC-III, and collect 1,246 unique queries with 77,206 relevance judgments by further leveraging powerful LLMs as annotators. Additionally, we include a novel assessment of the semantic gap issue in EHR retrieval by categorizing matching types into string match and four types of semantic matches. On our proposed benchmark, we conduct a comprehensive evaluation of various retrieval methods, ranging from conventional exact match to popular dense retrievers. Our experiments find that BM25 sets a strong baseline and performs competitively to the dense retrievers, and general domain dense retrievers surprisingly outperform those designed for the medical domain. In-depth analyses on various matching types reveal the strengths and drawbacks of different methods, enlightening the potential for targeted improvement. We believe that our benchmark will stimulate the research communities to advance EHR retrieval systems.

Precise breast cancer classification on histopathological images has the potential to greatly improve the diagnosis and patient outcome in oncology. The data imbalance problem largely stems from the inherent imbalance within medical image datasets, where certain tumor subtypes may appear much less frequently. This constitutes a considerable limitation in biased model predictions that can overlook critical but rare classes. In this work, we adopted EfficientNet, a state-of-the-art convolutional neural network (CNN) model that balances high accuracy with computational cost efficiency. To address data imbalance, we introduce an intensive data augmentation pipeline and cost-sensitive learning, improving representation and ensuring that the model does not overly favor majority classes. This approach provides the ability to learn effectively from rare tumor types, improving its robustness. Additionally, we fine-tuned the model using transfer learning, where weights in the beginning trained on a binary classification task were adopted to multi-class classification, improving the capability to detect complex patterns within the BreakHis dataset. Our results underscore significant improvements in the binary classification performance, achieving an exceptional recall increase for benign cases from 0.92 to 0.95, alongside an accuracy enhancement from 97.35 % to 98.23%. Our approach improved the performance of multi-class tasks from 91.27% with regular augmentation to 94.54% with intensive augmentation, reaching 95.04% with transfer learning. This framework demonstrated substantial gains in precision in the minority classes, such as Mucinous carcinoma and Papillary carcinoma, while maintaining high recall consistently across these critical subtypes, as further confirmed by confusion matrix analysis.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

Millions of melanocytic skin lesions are examined by pathologists each year, the majority of which concern common nevi (i.e., ordinary moles). While most of these lesions can be diagnosed in seconds, writing the corresponding pathology report is much more time-consuming. Automating part of the report writing could, therefore, alleviate the increasing workload of pathologists. In this work, we develop a vision-language model specifically for the pathology domain of cutaneous melanocytic lesions. The model follows the Contrastive Captioner framework and was trained and evaluated using a melanocytic lesion dataset of 42,512 H&E-stained whole slide images and 19,645 corresponding pathology reports. Our results show that the quality scores of model-generated reports were on par with pathologist-written reports for common nevi, assessed by an expert pathologist in a reader study. While report generation revealed to be more difficult for rare melanocytic lesion subtypes, the cross-modal retrieval performance for these cases was considerably better.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

Retrieval-Augmented Generation (RAG) enhances recency and factuality in answers. However, existing evaluations rarely test how well these systems cope with real-world noise, conflicting between internal and external retrieved contexts, or fast-changing facts. We introduce Retrieval-Aware Robustness Evaluation (RARE), a unified framework and large-scale benchmark that jointly stress-tests query and document perturbations over dynamic, time-sensitive corpora. One of the central features of RARE is a knowledge-graph-driven synthesis pipeline (RARE-Get) that automatically extracts single and multi-hop relations from the customized corpus and generates multi-level question sets without manual intervention. Leveraging this pipeline, we construct a dataset (RARE-Set) spanning 400 expert-level time-sensitive finance, economics, and policy documents and 48,322 questions whose distribution evolves as the underlying sources change. To quantify resilience, we formalize retrieval-conditioned robustness metrics (RARE-Met) that capture a model's ability to remain correct or recover when queries, documents, or real-world retrieval results are systematically altered. Our results show that RAG systems exhibit surprising vulnerability to perturbations, with document robustness consistently being the weakest point regardless of generator size or architecture. RAG systems consistently show lower robustness on multi-hop queries than single-hop queries across all domains.

Deep learning has enabled the development of highly robust foundation models for various pathological tasks across diverse diseases and patient cohorts. Among these models, vision-language pre-training, which leverages large-scale paired data to align pathology image and text embedding spaces, and provides a novel zero-shot paradigm for downstream tasks. However, existing models have been primarily data-driven and lack the incorporation of domain-specific knowledge, which limits their performance in cancer diagnosis, especially for rare tumor subtypes. To address this limitation, we establish a Knowledge-enhanced Pathology (KEEP) foundation model that harnesses disease knowledge to facilitate vision-language pre-training. Specifically, we first construct a disease knowledge graph (KG) that covers 11,454 human diseases with 139,143 disease attributes, including synonyms, definitions, and hypernym relations. We then systematically reorganize the millions of publicly available noisy pathology image-text pairs, into 143K well-structured semantic groups linked through the hierarchical relations of the disease KG. To derive more nuanced image and text representations, we propose a novel knowledge-enhanced vision-language pre-training approach that integrates disease knowledge into the alignment within hierarchical semantic groups instead of unstructured image-text pairs. Validated on 18 diverse benchmarks with more than 14,000 whole slide images (WSIs), KEEP achieves state-of-the-art performance in zero-shot cancer diagnostic tasks. Notably, for cancer detection, KEEP demonstrates an average sensitivity of 89.8% at a specificity of 95.0% across 7 cancer types. For cancer subtyping, KEEP achieves a median balanced accuracy of 0.456 in subtyping 30 rare brain cancers, indicating strong generalizability for diagnosing rare tumors.

Medical information retrieval (MIR) is essential for retrieving relevant medical knowledge from diverse sources, including electronic health records, scientific literature, and medical databases. However, achieving effective zero-shot dense retrieval in the medical domain poses substantial challenges due to the lack of relevance-labeled data. In this paper, we introduce a novel approach called Self-Learning Hypothetical Document Embeddings (SL-HyDE) to tackle this issue. SL-HyDE leverages large language models (LLMs) as generators to generate hypothetical documents based on a given query. These generated documents encapsulate key medical context, guiding a dense retriever in identifying the most relevant documents. The self-learning framework progressively refines both pseudo-document generation and retrieval, utilizing unlabeled medical corpora without requiring any relevance-labeled data. Additionally, we present the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation framework grounded in real-world medical scenarios, encompassing five tasks and ten datasets. By benchmarking ten models on CMIRB, we establish a rigorous standard for evaluating medical information retrieval systems. Experimental results demonstrate that SL-HyDE significantly surpasses existing methods in retrieval accuracy while showcasing strong generalization and scalability across various LLM and retriever configurations. CMIRB data and evaluation code are publicly available at: https://github.com/CMIRB-benchmark/CMIRB.

Patient recruitment is challenging for clinical trials. We introduce TrialGPT, an end-to-end framework for zero-shot patient-to-trial matching with large language models. TrialGPT comprises three modules: it first performs large-scale filtering to retrieve candidate trials (TrialGPT-Retrieval); then predicts criterion-level patient eligibility (TrialGPT-Matching); and finally generates trial-level scores (TrialGPT-Ranking). We evaluate TrialGPT on three cohorts of 183 synthetic patients with over 75,000 trial annotations. TrialGPT-Retrieval can recall over 90% of relevant trials using less than 6% of the initial collection. Manual evaluations on 1,015 patient-criterion pairs show that TrialGPT-Matching achieves an accuracy of 87.3% with faithful explanations, close to the expert performance. The TrialGPT-Ranking scores are highly correlated with human judgments and outperform the best-competing models by 43.8% in ranking and excluding trials. Furthermore, our user study reveals that TrialGPT can reduce the screening time by 42.6% in patient recruitment. Overall, these results have demonstrated promising opportunities for patient-to-trial matching with TrialGPT.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

Rare diseases present unique challenges in healthcare, often suffering from delayed diagnosis and fragmented information landscapes. The scarcity of reliable knowledge in these conditions poses a distinct challenge for Large Language Models (LLMs) in supporting clinical management and delivering precise patient information underscoring the need for focused training on these 'zebra' cases. We present Zebra-Llama, a specialized context-aware language model with high precision Retrieval Augmented Generation (RAG) capability, focusing on Ehlers-Danlos Syndrome (EDS) as our case study. EDS, affecting 1 in 5,000 individuals, exemplifies the complexities of rare diseases with its diverse symptoms, multiple subtypes, and evolving diagnostic criteria. By implementing a novel context-aware fine-tuning methodology trained on questions derived from medical literature, patient experiences, and clinical resources, along with expertly curated responses, Zebra-Llama demonstrates unprecedented capabilities in handling EDS-related queries. On a test set of real-world questions collected from EDS patients and clinicians, medical experts evaluated the responses generated by both models, revealing Zebra-Llama's substantial improvements over base model (Llama 3.1-8B-Instruct) in thoroughness (77.5% vs. 70.1%), accuracy (83.0% vs. 78.8%), clarity (74.7% vs. 72.0%) and citation reliability (70.6% vs. 52.3%). Released as an open-source resource, Zebra-Llama not only provides more accessible and reliable EDS information but also establishes a framework for developing specialized AI solutions for other rare conditions. This work represents a crucial step towards democratizing expert-level knowledge in rare disease management, potentially transforming how healthcare providers and patients navigate the complex landscape of rare diseases.

High Recall Retrieval (HRR), such as eDiscovery and medical systematic review, is a search problem that optimizes the cost of retrieving most relevant documents in a given collection. Iterative approaches, such as iterative relevance feedback and uncertainty sampling, are shown to be effective under various operational scenarios. Despite neural models demonstrating success in other text-related tasks, linear models such as logistic regression, in general, are still more effective and efficient in HRR since the model is trained and retrieves documents from the same fixed collection. In this work, we leverage SPLADE, an efficient retrieval model that transforms documents into contextualized sparse vectors, for HRR. Our approach combines the best of both worlds, leveraging both the contextualization from pretrained language models and the efficiency of linear models. It reduces 10% and 18% of the review cost in two HRR evaluation collections under a one-phase review workflow with a target recall of 80%. The experiment is implemented with TARexp and is available at https://github.com/eugene-yang/LSR-for-TAR.

Rare diseases collectively affect over 300 million individuals worldwide, yet timely and accurate diagnosis remains a pervasive challenge. This is largely due to their clinical heterogeneity, low individual prevalence, and the limited familiarity most clinicians have with rare conditions. Here, we introduce DeepRare, the first rare disease diagnosis agentic system powered by a large language model (LLM), capable of processing heterogeneous clinical inputs. The system generates ranked diagnostic hypotheses for rare diseases, each accompanied by a transparent chain of reasoning that links intermediate analytic steps to verifiable medical evidence. DeepRare comprises three key components: a central host with a long-term memory module; specialized agent servers responsible for domain-specific analytical tasks integrating over 40 specialized tools and web-scale, up-to-date medical knowledge sources, ensuring access to the most current clinical information. This modular and scalable design enables complex diagnostic reasoning while maintaining traceability and adaptability. We evaluate DeepRare on eight datasets. The system demonstrates exceptional diagnostic performance among 2,919 diseases, achieving 100% accuracy for 1013 diseases. In HPO-based evaluations, DeepRare significantly outperforms other 15 methods, like traditional bioinformatics diagnostic tools, LLMs, and other agentic systems, achieving an average Recall@1 score of 57.18% and surpassing the second-best method (Reasoning LLM) by a substantial margin of 23.79 percentage points. For multi-modal input scenarios, DeepRare achieves 70.60% at Recall@1 compared to Exomiser's 53.20% in 109 cases. Manual verification of reasoning chains by clinical experts achieves 95.40% agreements. Furthermore, the DeepRare system has been implemented as a user-friendly web application http://raredx.cn/doctor.

We present strong Transformer-based re-ranking and dense retrieval baselines for the recently released TripClick health ad-hoc retrieval collection. We improve the - originally too noisy - training data with a simple negative sampling policy. We achieve large gains over BM25 in the re-ranking task of TripClick, which were not achieved with the original baselines. Furthermore, we study the impact of different domain-specific pre-trained models on TripClick. Finally, we show that dense retrieval outperforms BM25 by considerable margins, even with simple training procedures.

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

Textual health records of cancer patients are usually protracted and highly unstructured, making it very time-consuming for health professionals to get a complete overview of the patient's therapeutic course. As such limitations can lead to suboptimal and/or inefficient treatment procedures, healthcare providers would greatly benefit from a system that effectively summarizes the information of those records. With the advent of deep neural models, this objective has been partially attained for English clinical texts, however, the research community still lacks an effective solution for languages with limited resources. In this paper, we present the approach we developed to extract procedures, drugs, and diseases from oncology health records written in European Portuguese. This project was conducted in collaboration with the Portuguese Institute for Oncology which, besides holding over 10 years of duly protected medical records, also provided oncologist expertise throughout the development of the project. Since there is no annotated corpus for biomedical entity extraction in Portuguese, we also present the strategy we followed in annotating the corpus for the development of the models. The final models, which combined a neural architecture with entity linking, achieved F_1 scores of 88.6, 95.0, and 55.8 per cent in the mention extraction of procedures, drugs, and diseases, respectively.

Large Language Models (LLMs) have shown remarkable capabilities in general domains but often struggle with tasks requiring specialized knowledge. Conventional Retrieval-Augmented Generation (RAG) techniques typically retrieve external information from static knowledge bases, which can be outdated or incomplete, missing fine-grained clinical details essential for accurate medical question answering. In this work, we propose SearchRAG, a novel framework that overcomes these limitations by leveraging real-time search engines. Our method employs synthetic query generation to convert complex medical questions into search-engine-friendly queries and utilizes uncertainty-based knowledge selection to filter and incorporate the most relevant and informative medical knowledge into the LLM's input. Experimental results demonstrate that our method significantly improves response accuracy in medical question answering tasks, particularly for complex questions requiring detailed and up-to-date knowledge.

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

While large language models (LLMs) have achieved state-of-the-art performance on a wide range of medical question answering (QA) tasks, they still face challenges with hallucinations and outdated knowledge. Retrieval-augmented generation (RAG) is a promising solution and has been widely adopted. However, a RAG system can involve multiple flexible components, and there is a lack of best practices regarding the optimal RAG setting for various medical purposes. To systematically evaluate such systems, we propose the Medical Information Retrieval-Augmented Generation Evaluation (MIRAGE), a first-of-its-kind benchmark including 7,663 questions from five medical QA datasets. Using MIRAGE, we conducted large-scale experiments with over 1.8 trillion prompt tokens on 41 combinations of different corpora, retrievers, and backbone LLMs through the MedRAG toolkit introduced in this work. Overall, MedRAG improves the accuracy of six different LLMs by up to 18% over chain-of-thought prompting, elevating the performance of GPT-3.5 and Mixtral to GPT-4-level. Our results show that the combination of various medical corpora and retrievers achieves the best performance. In addition, we discovered a log-linear scaling property and the "lost-in-the-middle" effects in medical RAG. We believe our comprehensive evaluations can serve as practical guidelines for implementing RAG systems for medicine.

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

Developing effective biomedical retrieval models is important for excelling at knowledge-intensive biomedical tasks but still challenging due to the deficiency of sufficient publicly annotated biomedical data and computational resources. We present BMRetriever, a series of dense retrievers for enhancing biomedical retrieval via unsupervised pre-training on large biomedical corpora, followed by instruction fine-tuning on a combination of labeled datasets and synthetic pairs. Experiments on 5 biomedical tasks across 11 datasets verify BMRetriever's efficacy on various biomedical applications. BMRetriever also exhibits strong parameter efficiency, with the 410M variant outperforming baselines up to 11.7 times larger, and the 2B variant matching the performance of models with over 5B parameters. The training data and model checkpoints are released at https://huggingface.co/BMRetriever to ensure transparency, reproducibility, and application to new domains.

Medical benchmark datasets significantly contribute to developing Large Language Models (LLMs) for medical knowledge extraction, diagnosis, summarization, and other uses. Yet, current benchmarks are mainly derived from exam questions given to medical students or cases described in the medical literature, lacking the complexity of real-world patient cases that deviate from classic textbook abstractions. These include rare diseases, uncommon presentations of common diseases, and unexpected treatment responses. Here, we construct Clinically Uncommon Patient Cases and Diagnosis Dataset (CUPCase) based on 3,562 real-world case reports from BMC, including diagnoses in open-ended textual format and as multiple-choice options with distractors. Using this dataset, we evaluate the ability of state-of-the-art LLMs, including both general-purpose and Clinical LLMs, to identify and correctly diagnose a patient case, and test models' performance when only partial information about cases is available. Our findings show that general-purpose GPT-4o attains the best performance in both the multiple-choice task (average accuracy of 87.9%) and the open-ended task (BERTScore F1 of 0.764), outperforming several LLMs with a focus on the medical domain such as Meditron-70B and MedLM-Large. Moreover, GPT-4o was able to maintain 87% and 88% of its performance with only the first 20% of tokens of the case presentation in multiple-choice and free text, respectively, highlighting the potential of LLMs to aid in early diagnosis in real-world cases. CUPCase expands our ability to evaluate LLMs for clinical decision support in an open and reproducible manner.

Retrieval-augmented models have proven to be effective in natural language processing tasks, yet there remains a lack of research on their optimization using variational inference. We introduce the Variational Open-Domain (VOD) framework for end-to-end training and evaluation of retrieval-augmented models, focusing on open-domain question answering and language modelling. The VOD objective, a self-normalized estimate of the R\'enyi variational bound, approximates the task marginal likelihood and is evaluated under samples drawn from an auxiliary sampling distribution (cached retriever and/or approximate posterior). It remains tractable, even for retriever distributions defined on large corpora. We demonstrate VOD's versatility by training reader-retriever BERT-sized models on multiple-choice medical exam questions. On the MedMCQA dataset, we outperform the domain-tuned Med-PaLM by +5.3% despite using 2.500times fewer parameters. Our retrieval-augmented BioLinkBERT model scored 62.9% on the MedMCQA and 55.0% on the MedQA-USMLE. Last, we show the effectiveness of our learned retriever component in the context of medical semantic search.

While generative modeling has become prevalent across numerous research fields, its integration into the realm of image retrieval remains largely unexplored and underjustified. In this paper, we present a novel methodology, reframing image retrieval as a variant of generative modeling and employing a sequence-to-sequence model. This approach is harmoniously aligned with the current trend towards unification in research, presenting a cohesive framework that allows for end-to-end differentiable searching. This, in turn, facilitates superior performance via direct optimization techniques. The development of our model, dubbed IRGen, addresses the critical technical challenge of converting an image into a concise sequence of semantic units, which is pivotal for enabling efficient and effective search. Extensive experiments demonstrate that our model achieves state-of-the-art performance on three widely-used image retrieval benchmarks as well as two million-scale datasets, yielding significant improvement compared to prior competitive retrieval methods. In addition, the notable surge in precision scores facilitated by generative modeling presents the potential to bypass the reranking phase, which is traditionally indispensable in practical retrieval workflows.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Rerankers play a critical role in multimodal Retrieval-Augmented Generation (RAG) by refining ranking of an initial set of retrieved documents. Rerankers are typically trained using hard negative mining, whose goal is to select pages for each query which rank high, but are actually irrelevant. However, this selection process is typically passive and restricted to what the retriever can find in the available corpus, leading to several inherent limitations. These include: limited diversity, negative examples which are often not hard enough, low controllability, and frequent false negatives which harm training. Our paper proposes an alternative approach: Single-Page Hard Negative Query Generation, which goes the other way around. Instead of retrieving negative pages per query, we generate hard negative queries per page. Using an automated LLM-VLM pipeline, and given a page and its positive query, we create hard negatives by rephrasing the query to be as similar as possible in form and context, yet not answerable from the page. This paradigm enables fine-grained control over the generated queries, resulting in diverse, hard, and targeted negatives. It also supports efficient false negative verification. Our experiments show that rerankers trained with data generated using our approach outperform existing models and significantly improve retrieval performance.

Ranking has always been one of the top concerns in information retrieval researches. For decades, the lexical matching signal has dominated the ad-hoc retrieval process, but solely using this signal in retrieval may cause the vocabulary mismatch problem. In recent years, with the development of representation learning techniques, many researchers turn to Dense Retrieval (DR) models for better ranking performance. Although several existing DR models have already obtained promising results, their performance improvement heavily relies on the sampling of training examples. Many effective sampling strategies are not efficient enough for practical usage, and for most of them, there still lacks theoretical analysis in how and why performance improvement happens. To shed light on these research questions, we theoretically investigate different training strategies for DR models and try to explain why hard negative sampling performs better than random sampling. Through the analysis, we also find that there are many potential risks in static hard negative sampling, which is employed by many existing training methods. Therefore, we propose two training strategies named a Stable Training Algorithm for dense Retrieval (STAR) and a query-side training Algorithm for Directly Optimizing Ranking pErformance (ADORE), respectively. STAR improves the stability of DR training process by introducing random negatives. ADORE replaces the widely-adopted static hard negative sampling method with a dynamic one to directly optimize the ranking performance. Experimental results on two publicly available retrieval benchmark datasets show that either strategy gains significant improvements over existing competitive baselines and a combination of them leads to the best performance.

State-of-the-art retrieval models typically address a straightforward search scenario, where retrieval tasks are fixed (e.g., finding a passage to answer a specific question) and only a single modality is supported for both queries and retrieved results. This paper introduces techniques for advancing information retrieval with multimodal large language models (MLLMs), enabling a broader search scenario, termed universal multimodal retrieval, where multiple modalities and diverse retrieval tasks are accommodated. To this end, we first study fine-tuning an MLLM as a bi-encoder retriever on 10 datasets with 16 retrieval tasks. Our empirical results show that the fine-tuned MLLM retriever is capable of understanding challenging queries, composed of both text and image, but underperforms a smaller CLIP retriever in cross-modal retrieval tasks due to modality bias from MLLMs. To address the issue, we propose modality-aware hard negative mining to mitigate the modality bias exhibited by MLLM retrievers. Second, we propose to continually fine-tune the universal multimodal retriever to enhance its text retrieval capability while maintaining multimodal retrieval capability. As a result, our model, MM-Embed, achieves state-of-the-art performance on the multimodal retrieval benchmark M-BEIR, which spans multiple domains and tasks, while also surpassing the state-of-the-art text retrieval model, NV-Embed-v1, on MTEB retrieval benchmark. Finally, we explore to prompt the off-the-shelf MLLMs as the zero-shot rerankers to refine the ranking of the candidates from the multimodal retriever. We find that through prompt-and-reranking, MLLMs can further improve multimodal retrieval when the user queries (e.g., text-image composed queries) are more complex and challenging to understand. These findings also pave the way to advance universal multimodal retrieval in the future.

Rare diseases, including Inborn Errors of Metabolism (IEM), pose significant diagnostic challenges. Case reports serve as key but computationally underutilized resources to inform diagnosis. Clinical dense information extraction refers to organizing medical information into structured predefined categories. Large Language Models (LLMs) may enable scalable information extraction from case reports but are rarely evaluated for this task. We introduce CaseReportBench, an expert-annotated dataset for dense information extraction of case reports, focusing on IEMs. Using this dataset, we assess various models and prompting strategies, introducing novel approaches such as category-specific prompting and subheading-filtered data integration. Zero-shot chain-of-thought prompting offers little advantage over standard zero-shot prompting. Category-specific prompting improves alignment with the benchmark. The open-source model Qwen2.5-7B outperforms GPT-4o for this task. Our clinician evaluations show that LLMs can extract clinically relevant details from case reports, supporting rare disease diagnosis and management. We also highlight areas for improvement, such as LLMs' limitations in recognizing negative findings important for differential diagnosis. This work advances LLM-driven clinical natural language processing and paves the way for scalable medical AI applications.

Foundation models are reshaping computational pathology by enabling transfer learning, where models pre-trained on vast datasets can be adapted for downstream diagnostic, prognostic, and therapeutic response tasks. Despite these advances, foundation models are still limited in their ability to encode the entire gigapixel whole-slide images without additional training and often lack complementary multimodal data. Here, we introduce Threads, a slide-level foundation model capable of generating universal representations of whole-slide images of any size. Threads was pre-trained using a multimodal learning approach on a diverse cohort of 47,171 hematoxylin and eosin (H&E)-stained tissue sections, paired with corresponding genomic and transcriptomic profiles - the largest such paired dataset to be used for foundation model development to date. This unique training paradigm enables Threads to capture the tissue's underlying molecular composition, yielding powerful representations applicable to a wide array of downstream tasks. In extensive benchmarking across 54 oncology tasks, including clinical subtyping, grading, mutation prediction, immunohistochemistry status determination, treatment response prediction, and survival prediction, Threads outperformed all baselines while demonstrating remarkable generalizability and label efficiency. It is particularly well suited for predicting rare events, further emphasizing its clinical utility. We intend to make the model publicly available for the broader community.

Developing accurate machine learning models for oncology requires large-scale, high-quality multimodal datasets. However, creating such datasets remains challenging due to the complexity and heterogeneity of medical data. To address this challenge, we introduce HoneyBee, a scalable modular framework for building multimodal oncology datasets that leverages foundational models to generate representative embeddings. HoneyBee integrates various data modalities, including clinical records, imaging data, and patient outcomes. It employs data preprocessing techniques and transformer-based architectures to generate embeddings that capture the essential features and relationships within the raw medical data. The generated embeddings are stored in a structured format using Hugging Face datasets and PyTorch dataloaders for accessibility. Vector databases enable efficient querying and retrieval for machine learning applications. We demonstrate the effectiveness of HoneyBee through experiments assessing the quality and representativeness of the embeddings. The framework is designed to be extensible to other medical domains and aims to accelerate oncology research by providing high-quality, machine learning-ready datasets. HoneyBee is an ongoing open-source effort, and the code, datasets, and models are available at the project repository.

Biomedical question-answering (QA) systems require effective retrieval and generation components to ensure accuracy, efficiency, and scalability. This study systematically examines a Retrieval-Augmented Generation (RAG) system for biomedical QA, evaluating retrieval strategies and response time trade-offs. We first assess state-of-the-art retrieval methods, including BM25, BioBERT, MedCPT, and a hybrid approach, alongside common data stores such as Elasticsearch, MongoDB, and FAISS, on a ~10% subset of PubMed (2.4M documents) to measure indexing efficiency, retrieval latency, and retriever performance in the end-to-end RAG system. Based on these insights, we deploy the final RAG system on the full 24M PubMed corpus, comparing different retrievers' impact on overall performance. Evaluations of the retrieval depth show that retrieving 50 documents with BM25 before reranking with MedCPT optimally balances accuracy (0.90), recall (0.90), and response time (1.91s). BM25 retrieval time remains stable (82ms), while MedCPT incurs the main computational cost. These results highlight previously not well-known trade-offs in retrieval depth, efficiency, and scalability for biomedical QA. With open-source code, the system is fully reproducible and extensible.

In common law jurisdictions, legal practitioners rely on precedents to construct arguments, in line with the doctrine of stare decisis. As the number of cases grow over the years, prior case retrieval (PCR) has garnered significant attention. Besides lacking real-world scale, existing PCR datasets do not simulate a realistic setting, because their queries use complete case documents while only masking references to prior cases. The query is thereby exposed to legal reasoning not yet available when constructing an argument for an undecided case as well as spurious patterns left behind by citation masks, potentially short-circuiting a comprehensive understanding of case facts and legal principles. To address these limitations, we introduce a PCR dataset based on judgements from the European Court of Human Rights (ECtHR), which explicitly separate facts from arguments and exhibit precedential practices, aiding us to develop this PCR dataset to foster systems' comprehensive understanding. We benchmark different lexical and dense retrieval approaches with various negative sampling strategies, adapting them to deal with long text sequences using hierarchical variants. We found that difficulty-based negative sampling strategies were not effective for the PCR task, highlighting the need for investigation into domain-specific difficulty criteria. Furthermore, we observe performance of the dense models degrade with time and calls for further research into temporal adaptation of retrieval models. Additionally, we assess the influence of different views , Halsbury's and Goodhart's, in practice in ECtHR jurisdiction using PCR task.

We introduce a novel graph-based Retrieval-Augmented Generation (RAG) framework specifically designed for the medical domain, called MedGraphRAG, aimed at enhancing Large Language Model (LLM) capabilities and generating evidence-based results, thereby improving safety and reliability when handling private medical data. Our comprehensive pipeline begins with a hybrid static-semantic approach to document chunking, significantly improving context capture over traditional methods. Extracted entities are used to create a three-tier hierarchical graph structure, linking entities to foundational medical knowledge sourced from medical papers and dictionaries. These entities are then interconnected to form meta-graphs, which are merged based on semantic similarities to develop a comprehensive global graph. This structure supports precise information retrieval and response generation. The retrieval process employs a U-retrieve method to balance global awareness and indexing efficiency of the LLM. Our approach is validated through a comprehensive ablation study comparing various methods for document chunking, graph construction, and information retrieval. The results not only demonstrate that our hierarchical graph construction method consistently outperforms state-of-the-art models on multiple medical Q\&A benchmarks, but also confirms that the responses generated include source documentation, significantly enhancing the reliability of medical LLMs in practical applications. Code will be at: https://github.com/MedicineToken/Medical-Graph-RAG/tree/main

Large language models achieve high task performance yet often hallucinate or rely on outdated knowledge. Retrieval-augmented generation (RAG) addresses these gaps by coupling generation with external search. We analyse how hyperparameters influence speed and quality in RAG systems, covering Chroma and Faiss vector stores, chunking policies, cross-encoder re-ranking, and temperature, and we evaluate six metrics: faithfulness, answer correctness, answer relevancy, context precision, context recall, and answer similarity. Chroma processes queries 13% faster, whereas Faiss yields higher retrieval precision, revealing a clear speed-accuracy trade-off. Naive fixed-length chunking with small windows and minimal overlap outperforms semantic segmentation while remaining the quickest option. Re-ranking provides modest gains in retrieval quality yet increases runtime by roughly a factor of 5, so its usefulness depends on latency constraints. These results help practitioners balance computational cost and accuracy when tuning RAG systems for transparent, up-to-date responses. Finally, we re-evaluate the top configurations with a corrective RAG workflow and show that their advantages persist when the model can iteratively request additional evidence. We obtain a near-perfect context precision (99%), which demonstrates that RAG systems can achieve extremely high retrieval accuracy with the right combination of hyperparameters, with significant implications for applications where retrieval quality directly impacts downstream task performance, such as clinical decision support in healthcare.

The recent emergence of Medical Large Vision Language Models (Med-LVLMs) has enhanced medical diagnosis. However, current Med-LVLMs frequently encounter factual issues, often generating responses that do not align with established medical facts. Retrieval-Augmented Generation (RAG), which utilizes external knowledge, can improve the factual accuracy of these models but introduces two major challenges. First, limited retrieved contexts might not cover all necessary information, while excessive retrieval can introduce irrelevant and inaccurate references, interfering with the model's generation. Second, in cases where the model originally responds correctly, applying RAG can lead to an over-reliance on retrieved contexts, resulting in incorrect answers. To address these issues, we propose RULE, which consists of two components. First, we introduce a provably effective strategy for controlling factuality risk through the calibrated selection of the number of retrieved contexts. Second, based on samples where over-reliance on retrieved contexts led to errors, we curate a preference dataset to fine-tune the model, balancing its dependence on inherent knowledge and retrieved contexts for generation. We demonstrate the effectiveness of RULE on three medical VQA datasets, achieving an average improvement of 20.8% in factual accuracy. We publicly release our benchmark and code in https://github.com/richard-peng-xia/RULE.

The recent surge of foundation models in computer vision and natural language processing opens up perspectives in utilizing multi-modal clinical data to train large models with strong generalizability. Yet pathological image datasets often lack biomedical text annotation and enrichment. Guiding data-efficient image diagnosis from the use of biomedical text knowledge becomes a substantial interest. In this paper, we propose to Connect Image and Text Embeddings (CITE) to enhance pathological image classification. CITE injects text insights gained from language models pre-trained with a broad range of biomedical texts, leading to adapt foundation models towards pathological image understanding. Through extensive experiments on the PatchGastric stomach tumor pathological image dataset, we demonstrate that CITE achieves leading performance compared with various baselines especially when training data is scarce. CITE offers insights into leveraging in-domain text knowledge to reinforce data-efficient pathological image classification. Code is available at https://github.com/Yunkun-Zhang/CITE.

Large language models (LLMs) have grown in their usage to provide support for question answering across numerous disciplines. The models on their own have already shown promise for answering basic questions, however fail quickly where expert domain knowledge is required or the question is nuanced. Scientific research often involves searching for relevant literature, distilling pertinent information from that literature and analysing how the findings support or contradict one another. The information is often encapsulated in the full text body of research articles, rather than just in the abstracts. Statements within these articles frequently require the wider article context to be fully understood. We have built an LLM-based system that performs such search and distillation of information encapsulated in scientific literature, and we evaluate our keyword based search and information distillation system against a set of biology related questions from previously released literature benchmarks. We demonstrate sparse retrieval methods exhibit results close to state of the art without the need for dense retrieval, with its associated infrastructure and complexity overhead. We also show how to increase the coverage of relevant documents for literature review generation.

Whole-Slide Image (WSI) is an important tool for evaluating the prognosis of cancer patients. Present WSI-based prognosis studies generally follow a conventional paradigm -- cancer-specific model development -- where one cancer disease corresponds to one model and this model cannot make use of the prognostic knowledge from others. Despite its notable success in recent years, this paradigm has inherent limitations and has always been struggling with practical requirements: (i) scaling to the rare tumor diseases with very limited samples and (ii) benefiting from the generalizable prognostic knowledge in other cancers. To this end, this paper presents the first systematic study on Prognostic Knowledge Transfer in Pathology, called Path-PKT. It comprises three main parts. (1) We curate a large dataset (UNI2-h-DSS) with 13 cancers and use it to evaluate the transferability of prognostic knowledge between different cancers computationally. (2) We design experiments to understand what factors affect knowledge transfer and what causes positive transfers. (3) Motivated by empirical findings, we propose a new baseline approach (MoE-PKT) with a routing mechanism to utilize the generalizable prognostic knowledge in other cancers. Finally, we show the transferability of source models to rare tumor diseases. This study could lay solid foundations for the study of knowledge transfer in WSI-based cancer prognosis. Source code is available at https://github.com/liupei101/Path-PKT.

Retrieval-augmented generation (RAG) has emerged as a promising approach to enhance the performance of large language models (LLMs) in knowledge-intensive tasks such as those from medical domain. However, the sensitive nature of the medical domain necessitates a completely accurate and trustworthy system. While existing RAG benchmarks primarily focus on the standard retrieve-answer setting, they overlook many practical scenarios that measure crucial aspects of a reliable medical system. This paper addresses this gap by providing a comprehensive evaluation framework for medical question-answering (QA) systems in a RAG setting for these situations, including sufficiency, integration, and robustness. We introduce Medical Retrieval-Augmented Generation Benchmark (MedRGB) that provides various supplementary elements to four medical QA datasets for testing LLMs' ability to handle these specific scenarios. Utilizing MedRGB, we conduct extensive evaluations of both state-of-the-art commercial LLMs and open-source models across multiple retrieval conditions. Our experimental results reveals current models' limited ability to handle noise and misinformation in the retrieved documents. We further analyze the LLMs' reasoning processes to provides valuable insights and future directions for developing RAG systems in this critical medical domain.

Learned sparse retrieval, which can efficiently perform retrieval through mature inverted-index engines, has garnered growing attention in recent years. Particularly, the inference-free sparse retrievers are attractive as they eliminate online model inference in the retrieval phase thereby avoids huge computational cost, offering reasonable throughput and latency. However, even the state-of-the-art (SOTA) inference-free sparse models lag far behind in terms of search relevance when compared to both sparse and dense siamese models. Towards competitive search relevance for inference-free sparse retrievers, we argue that they deserve dedicated training methods other than using same ones with siamese encoders. In this paper, we propose two different approaches for performance improvement. First, we introduce the IDF-aware FLOPS loss, which introduces Inverted Document Frequency (IDF) to the sparsification of representations. We find that it mitigates the negative impact of the FLOPS regularization on search relevance, allowing the model to achieve a better balance between accuracy and efficiency. Moreover, we propose a heterogeneous ensemble knowledge distillation framework that combines siamese dense and sparse retrievers to generate supervisory signals during the pre-training phase. The ensemble framework of dense and sparse retriever capitalizes on their strengths respectively, providing a strong upper bound for knowledge distillation. To concur the diverse feedback from heterogeneous supervisors, we normalize and then aggregate the outputs of the teacher models to eliminate score scale differences. On the BEIR benchmark, our model outperforms existing SOTA inference-free sparse model by 3.3 NDCG@10 score. It exhibits search relevance comparable to siamese sparse retrievers and client-side latency only 1.1x that of BM25.

Much recent research on information retrieval has focused on how to transfer from one task (typically with abundant supervised data) to various other tasks where supervision is limited, with the implicit assumption that it is possible to generalize from one task to all the rest. However, this overlooks the fact that there are many diverse and unique retrieval tasks, each targeting different search intents, queries, and search domains. In this paper, we suggest to work on Few-shot Dense Retrieval, a setting where each task comes with a short description and a few examples. To amplify the power of a few examples, we propose Prompt-base Query Generation for Retriever (Promptagator), which leverages large language models (LLM) as a few-shot query generator, and creates task-specific retrievers based on the generated data. Powered by LLM's generalization ability, Promptagator makes it possible to create task-specific end-to-end retrievers solely based on a few examples {without} using Natural Questions or MS MARCO to train %question generators or dual encoders. Surprisingly, LLM prompting with no more than 8 examples allows dual encoders to outperform heavily engineered models trained on MS MARCO like ColBERT v2 by more than 1.2 nDCG on average on 11 retrieval sets. Further training standard-size re-rankers using the same generated data yields another 5.0 point nDCG improvement. Our studies determine that query generation can be far more effective than previously observed, especially when a small amount of task-specific knowledge is given.

Popularized by the Differentiable Search Index, the emerging paradigm of generative retrieval re-frames the classic information retrieval problem into a sequence-to-sequence modeling task, forgoing external indices and encoding an entire document corpus within a single Transformer. Although many different approaches have been proposed to improve the effectiveness of generative retrieval, they have only been evaluated on document corpora on the order of 100k in size. We conduct the first empirical study of generative retrieval techniques across various corpus scales, ultimately scaling up to the entire MS MARCO passage ranking task with a corpus of 8.8M passages and evaluating model sizes up to 11B parameters. We uncover several findings about scaling generative retrieval to millions of passages; notably, the central importance of using synthetic queries as document representations during indexing, the ineffectiveness of existing proposed architecture modifications when accounting for compute cost, and the limits of naively scaling model parameters with respect to retrieval performance. While we find that generative retrieval is competitive with state-of-the-art dual encoders on small corpora, scaling to millions of passages remains an important and unsolved challenge. We believe these findings will be valuable for the community to clarify the current state of generative retrieval, highlight the unique challenges, and inspire new research directions.

With increasing demands for efficiency, information retrieval has developed a branch of sparse retrieval, further advancing towards inference-free retrieval where the documents are encoded during indexing time and there is no model-inference for queries. Existing sparse retrieval models rely on FLOPS regularization for sparsification, while this mechanism was originally designed for Siamese encoders, it is considered to be suboptimal in inference-free scenarios which is asymmetric. Previous attempts to adapt FLOPS for inference-free scenarios have been limited to rule-based methods, leaving the potential of sparsification approaches for inference-free retrieval models largely unexplored. In this paper, we explore ell_0 inspired sparsification manner for inference-free retrievers. Through comprehensive out-of-domain evaluation on the BEIR benchmark, our method achieves state-of-the-art performance among inference-free sparse retrieval models and is comparable to leading Siamese sparse retrieval models. Furthermore, we provide insights into the trade-off between retrieval effectiveness and computational efficiency, demonstrating practical value for real-world applications.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

Learned sparse retrieval systems aim to combine the effectiveness of contextualized language models with the scalability of conventional data structures such as inverted indexes. Nevertheless, the indexes generated by these systems exhibit significant deviations from the ones that use traditional retrieval models, leading to a discrepancy in the performance of existing query optimizations that were specifically developed for traditional structures. These disparities arise from structural variations in query and document statistics, including sub-word tokenization, leading to longer queries, smaller vocabularies, and different score distributions within posting lists. This paper introduces Block-Max Pruning (BMP), an innovative dynamic pruning strategy tailored for indexes arising in learned sparse retrieval environments. BMP employs a block filtering mechanism to divide the document space into small, consecutive document ranges, which are then aggregated and sorted on the fly, and fully processed only as necessary, guided by a defined safe early termination criterion or based on approximate retrieval requirements. Through rigorous experimentation, we show that BMP substantially outperforms existing dynamic pruning strategies, offering unparalleled efficiency in safe retrieval contexts and improved tradeoffs between precision and efficiency in approximate retrieval tasks.

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

The exponential surge in online health information, coupled with its increasing use by non-experts, highlights the pressing need for advanced Health Information Retrieval models that consider not only topical relevance but also the factual accuracy of the retrieved information, given the potential risks associated with health misinformation. To this aim, this paper introduces a solution driven by Retrieval-Augmented Generation (RAG), which leverages the capabilities of generative Large Language Models (LLMs) to enhance the retrieval of health-related documents grounded in scientific evidence. In particular, we propose a three-stage model: in the first stage, the user's query is employed to retrieve topically relevant passages with associated references from a knowledge base constituted by scientific literature. In the second stage, these passages, alongside the initial query, are processed by LLMs to generate a contextually relevant rich text (GenText). In the last stage, the documents to be retrieved are evaluated and ranked both from the point of view of topical relevance and factual accuracy by means of their comparison with GenText, either through stance detection or semantic similarity. In addition to calculating factual accuracy, GenText can offer a layer of explainability for it, aiding users in understanding the reasoning behind the retrieval. Experimental evaluation of our model on benchmark datasets and against baseline models demonstrates its effectiveness in enhancing the retrieval of both topically relevant and factually accurate health information, thus presenting a significant step forward in the health misinformation mitigation problem.

Information retrieval (IR) is essential in biomedical knowledge acquisition and clinical decision support. While recent progress has shown that language model encoders perform better semantic retrieval, training such models requires abundant query-article annotations that are difficult to obtain in biomedicine. As a result, most biomedical IR systems only conduct lexical matching. In response, we introduce BioCPT, a first-of-its-kind Contrastively Pre-trained Transformer model for zero-shot biomedical IR. To train BioCPT, we collected an unprecedented scale of 255 million user click logs from PubMed. With such data, we use contrastive learning to train a pair of closely-integrated retriever and re-ranker. Experimental results show that BioCPT sets new state-of-the-art performance on five biomedical IR tasks, outperforming various baselines including much larger models such as GPT-3-sized cpt-text-XL. In addition, BioCPT also generates better biomedical article and sentence representations for semantic evaluations. As such, BioCPT can be readily applied to various real-world biomedical IR tasks. BioCPT API and code are publicly available at https://github.com/ncbi/BioCPT.

In traditional RAG framework, the basic retrieval units are normally short. The common retrievers like DPR normally work with 100-word Wikipedia paragraphs. Such a design forces the retriever to search over a large corpus to find the `needle' unit. In contrast, the readers only need to extract answers from the short retrieved units. Such an imbalanced `heavy' retriever and `light' reader design can lead to sub-optimal performance. In order to alleviate the imbalance, we propose a new framework LongRAG, consisting of a `long retriever' and a `long reader'. LongRAG processes the entire Wikipedia into 4K-token units, which is 30x longer than before. By increasing the unit size, we significantly reduce the total units from 22M to 700K. This significantly lowers the burden of retriever, which leads to a remarkable retrieval score: answer recall@1=71% on NQ (previously 52%) and answer recall@2=72% (previously 47%) on HotpotQA (full-wiki). Then we feed the top-k retrieved units (approx 30K tokens) to an existing long-context LLM to perform zero-shot answer extraction. Without requiring any training, LongRAG achieves an EM of 62.7% on NQ, which is the best known result. LongRAG also achieves 64.3% on HotpotQA (full-wiki), which is on par of the SoTA model. Our study offers insights into the future roadmap for combining RAG with long-context LLMs.

Precision medicine, such as patient-adaptive treatments assisted by medical image analysis, poses new challenges for segmentation algorithms in adapting to new patients, due to the large variability across different patients and the limited availability of annotated data for each patient. In this work, we propose a data-efficient segmentation algorithm, namely Part-aware Prompted Segment Anything Model (P^2SAM). Without any model fine-tuning, P^2SAM enables seamless adaptation to any new patients relying only on one-shot patient-specific data. We introduce a novel part-aware prompt mechanism to select multiple-point prompts based on the part-level features of the one-shot data, which can be extensively integrated into different promptable segmentation models, such as SAM and SAM 2. Moreover, to determine the optimal number of parts for each specific case, we propose a distribution-guided retrieval approach that further enhances the robustness of the part-aware prompt mechanism. P^2SAM improves the performance by +8.0% and +2.0% mean Dice score for two different patient-adaptive segmentation applications, respectively. In addition, P^2SAM also exhibits impressive generalizability in other adaptive segmentation tasks in the natural image domain, e.g., +6.4% mIoU within personalized object segmentation task. The code is available at: https://github.com/Zch0414/p2sam

Despite the widespread exploration of Retrieval-Augmented Generation (RAG), its deployment in enterprises for domain-specific datasets remains limited due to poor answer accuracy. These corpora, often shielded behind firewalls in private enterprise knowledge bases, having complex, domain-specific terminology, rarely seen by LLMs during pre-training; exhibit significant semantic variability across domains (like networking, military, or legal, etc.), or even within a single domain like medicine, and thus result in poor context precision for RAG systems. Currently, in such situations, fine-tuning or RAG with fine-tuning is attempted, but these approaches are slow, expensive, and lack generalization for accuracy as the new domain-specific data emerges. We propose an approach for Enterprise Search that focuses on enhancing the retriever for a domain-specific corpus through hybrid query indexes and metadata enrichment. This 'MetaGen Blended RAG' method constructs a metadata generation pipeline using key concepts, topics, and acronyms, and then creates a metadata-enriched hybrid index with boosted search queries. This approach avoids overfitting and generalizes effectively across domains. On the PubMedQA benchmark for the biomedical domain, the proposed method achieves 82% retrieval accuracy and 77% RAG accuracy, surpassing all previous RAG accuracy results without fine-tuning and sets a new benchmark for zero-shot results while outperforming much larger models like GPT3.5. The results are even comparable to the best fine-tuned models on this dataset, and we further demonstrate the robustness and scalability of the approach by evaluating it on other Q&A datasets like SQuAD, NQ etc.

Recent developments in representational learning for information retrieval can be organized in a conceptual framework that establishes two pairs of contrasts: sparse vs. dense representations and unsupervised vs. learned representations. Sparse learned representations can further be decomposed into expansion and term weighting components. This framework allows us to understand the relationship between recently proposed techniques such as DPR, ANCE, DeepCT, DeepImpact, and COIL, and furthermore, gaps revealed by our analysis point to "low hanging fruit" in terms of techniques that have yet to be explored. We present a novel technique dubbed "uniCOIL", a simple extension of COIL that achieves to our knowledge the current state-of-the-art in sparse retrieval on the popular MS MARCO passage ranking dataset. Our implementation using the Anserini IR toolkit is built on the Lucene search library and thus fully compatible with standard inverted indexes.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Diffusion models enable high-quality and diverse visual content synthesis. However, they struggle to generate rare or unseen concepts. To address this challenge, we explore the usage of Retrieval-Augmented Generation (RAG) with image generation models. We propose ImageRAG, a method that dynamically retrieves relevant images based on a given text prompt, and uses them as context to guide the generation process. Prior approaches that used retrieved images to improve generation, trained models specifically for retrieval-based generation. In contrast, ImageRAG leverages the capabilities of existing image conditioning models, and does not require RAG-specific training. Our approach is highly adaptable and can be applied across different model types, showing significant improvement in generating rare and fine-grained concepts using different base models. Our project page is available at: https://rotem-shalev.github.io/ImageRAG

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

Cancer patients are increasingly turning to large language models (LLMs) as a new form of internet search for medical information, making it critical to assess how well these models handle complex, personalized questions. However, current medical benchmarks focus on medical exams or consumer-searched questions and do not evaluate LLMs on real patient questions with detailed clinical contexts. In this paper, we first evaluate LLMs on cancer-related questions drawn from real patients, reviewed by three hematology oncology physicians. While responses are generally accurate, with GPT-4-Turbo scoring 4.13 out of 5, the models frequently fail to recognize or address false presuppositions in the questions-posing risks to safe medical decision-making. To study this limitation systematically, we introduce Cancer-Myth, an expert-verified adversarial dataset of 585 cancer-related questions with false presuppositions. On this benchmark, no frontier LLM -- including GPT-4o, Gemini-1.Pro, and Claude-3.5-Sonnet -- corrects these false presuppositions more than 30% of the time. Even advanced medical agentic methods do not prevent LLMs from ignoring false presuppositions. These findings expose a critical gap in the clinical reliability of LLMs and underscore the need for more robust safeguards in medical AI systems.

Dense retrieval has made significant advancements in information retrieval (IR) by achieving high levels of effectiveness while maintaining online efficiency during a single-pass retrieval process. However, the application of pseudo relevance feedback (PRF) to further enhance retrieval effectiveness results in a doubling of online latency. To address this challenge, this paper presents a single-pass dense retrieval framework that shifts the PRF process offline through the utilization of pre-generated pseudo-queries. As a result, online retrieval is reduced to a single matching with the pseudo-queries, hence providing faster online retrieval. The effectiveness of the proposed approach is evaluated on the standard TREC DL and HARD datasets, and the results demonstrate its promise. Our code is openly available at https://github.com/Rosenberg37/OPRF.

Large Reasoning Models (LRMs) have demonstrated remarkable capabilities in multi-step reasoning and calling search engines at appropriate steps. However, existing retrieval-augmented reasoning approaches rely on separate retrieval models, limiting the LRM's role in retrieval to deciding when to retrieve and how to query. This separation not only increases hardware and operational costs but also leads to errors in the retrieval process due to the representation bottleneck, a phenomenon where the retriever's embedding space is not expressive enough to meet the generator's requirements. To address this, we shift our perspective from sequence-to-sequence matching to locating the answer-containing paths within the corpus, and propose a novel framework called FREESON (Retriever-FREE Retrieval-Augmented ReaSONing). This framework enables LRMs to retrieve relevant knowledge on their own by acting as both a generator and retriever. To achieve this, we introduce a variant of the MCTS algorithm specialized for the retrieval task, which we call CT-MCTS (Corpus-Traversing Monte Carlo Tree Search). In this algorithm, LRMs traverse through the corpus toward answer-containing regions. Our results on five open-domain QA benchmarks, including single-hop and multi-hop questions, show that FREESON achieves an average improvement of 14.4% in EM and F1 over four multi-step reasoning models with a separate retriever, and it also performs comparably to the strongest baseline, surpassing it by 3% on PopQA and 2WikiMultihopQA.

Pathology text mining is a challenging task given the reporting variability and constant new findings in cancer sub-type definitions. However, successful text mining of a large pathology database can play a critical role to advance 'big data' cancer research like similarity-based treatment selection, case identification, prognostication, surveillance, clinical trial screening, risk stratification, and many others. While there is a growing interest in developing language models for more specific clinical domains, no pathology-specific language space exist to support the rapid data-mining development in pathology space. In literature, a few approaches fine-tuned general transformer models on specialized corpora while maintaining the original tokenizer, but in fields requiring specialized terminology, these models often fail to perform adequately. We propose PathologyBERT - a pre-trained masked language model which was trained on 347,173 histopathology specimen reports and publicly released in the Huggingface repository. Our comprehensive experiments demonstrate that pre-training of transformer model on pathology corpora yields performance improvements on Natural Language Understanding (NLU) and Breast Cancer Diagnose Classification when compared to nonspecific language models.

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new Distill-Retrieve-Read framework instead of the previous Retrieve-then-Read. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

We introduce INQUIRE, a text-to-image retrieval benchmark designed to challenge multimodal vision-language models on expert-level queries. INQUIRE includes iNaturalist 2024 (iNat24), a new dataset of five million natural world images, along with 250 expert-level retrieval queries. These queries are paired with all relevant images comprehensively labeled within iNat24, comprising 33,000 total matches. Queries span categories such as species identification, context, behavior, and appearance, emphasizing tasks that require nuanced image understanding and domain expertise. Our benchmark evaluates two core retrieval tasks: (1) INQUIRE-Fullrank, a full dataset ranking task, and (2) INQUIRE-Rerank, a reranking task for refining top-100 retrievals. Detailed evaluation of a range of recent multimodal models demonstrates that INQUIRE poses a significant challenge, with the best models failing to achieve an mAP@50 above 50%. In addition, we show that reranking with more powerful multimodal models can enhance retrieval performance, yet there remains a significant margin for improvement. By focusing on scientifically-motivated ecological challenges, INQUIRE aims to bridge the gap between AI capabilities and the needs of real-world scientific inquiry, encouraging the development of retrieval systems that can assist with accelerating ecological and biodiversity research. Our dataset and code are available at https://inquire-benchmark.github.io

Clinical trial matching is a key process in health delivery and discovery. In practice, it is plagued by overwhelming unstructured data and unscalable manual processing. In this paper, we conduct a systematic study on scaling clinical trial matching using large language models (LLMs), with oncology as the focus area. Our study is grounded in a clinical trial matching system currently in test deployment at a large U.S. health network. Initial findings are promising: out of box, cutting-edge LLMs, such as GPT-4, can already structure elaborate eligibility criteria of clinical trials and extract complex matching logic (e.g., nested AND/OR/NOT). While still far from perfect, LLMs substantially outperform prior strong baselines and may serve as a preliminary solution to help triage patient-trial candidates with humans in the loop. Our study also reveals a few significant growth areas for applying LLMs to end-to-end clinical trial matching, such as context limitation and accuracy, especially in structuring patient information from longitudinal medical records.

Vision-language models in pathology enable multimodal case retrieval and automated report generation. Many of the models developed so far, however, have been trained on pathology reports that include information which cannot be inferred from paired whole slide images (e.g., patient history), potentially leading to hallucinated sentences in generated reports. To this end, we investigate how the selection of information from pathology reports for vision-language modeling affects the quality of the multimodal representations and generated reports. More concretely, we compare a model trained on full reports against a model trained on preprocessed reports that only include sentences describing the cell and tissue appearances based on the H&E-stained slides. For the experiments, we built upon the BLIP-2 framework and used a cutaneous melanocytic lesion dataset of 42,433 H&E-stained whole slide images and 19,636 corresponding pathology reports. Model performance was assessed using image-to-text and text-to-image retrieval, as well as qualitative evaluation of the generated reports by an expert pathologist. Our results demonstrate that text preprocessing prevents hallucination in report generation. Despite the improvement in the quality of the generated reports, training the vision-language model on full reports showed better cross-modal retrieval performance.

Developing clinical prediction models (e.g., mortality prediction) based on electronic health records (EHRs) typically relies on expert opinion for feature selection and adjusting observation window size. This burdens experts and creates a bottleneck in the development process. We propose Retrieval-Enhanced Medical prediction model (REMed) to address such challenges. REMed can essentially evaluate an unlimited number of clinical events, select the relevant ones, and make predictions. This approach effectively eliminates the need for manual feature selection and enables an unrestricted observation window. We verified these properties through experiments on 27 clinical tasks and two independent cohorts from publicly available EHR datasets, where REMed outperformed other contemporary architectures that aim to handle as many events as possible. Notably, we found that the preferences of REMed align closely with those of medical experts. We expect our approach to significantly expedite the development of EHR prediction models by minimizing clinicians' need for manual involvement.

This work introduces ILIAS, a new test dataset for Instance-Level Image retrieval At Scale. It is designed to evaluate the ability of current and future foundation models and retrieval techniques to recognize particular objects. The key benefits over existing datasets include large scale, domain diversity, accurate ground truth, and a performance that is far from saturated. ILIAS includes query and positive images for 1,000 object instances, manually collected to capture challenging conditions and diverse domains. Large-scale retrieval is conducted against 100 million distractor images from YFCC100M. To avoid false negatives without extra annotation effort, we include only query objects confirmed to have emerged after 2014, i.e. the compilation date of YFCC100M. An extensive benchmarking is performed with the following observations: i) models fine-tuned on specific domains, such as landmarks or products, excel in that domain but fail on ILIAS ii) learning a linear adaptation layer using multi-domain class supervision results in performance improvements, especially for vision-language models iii) local descriptors in retrieval re-ranking are still a key ingredient, especially in the presence of severe background clutter iv) the text-to-image performance of the vision-language foundation models is surprisingly close to the corresponding image-to-image case. website: https://vrg.fel.cvut.cz/ilias/

Generative retrieval is an emerging approach in information retrieval that generates identifiers (IDs) of target data based on a query, providing an efficient alternative to traditional embedding-based retrieval methods. However, existing models are task-specific and fall short of embedding-based retrieval in performance. This paper proposes GENIUS, a universal generative retrieval framework supporting diverse tasks across multiple modalities and domains. At its core, GENIUS introduces modality-decoupled semantic quantization, transforming multimodal data into discrete IDs encoding both modality and semantics. Moreover, to enhance generalization, we propose a query augmentation that interpolates between a query and its target, allowing GENIUS to adapt to varied query forms. Evaluated on the M-BEIR benchmark, it surpasses prior generative methods by a clear margin. Unlike embedding-based retrieval, GENIUS consistently maintains high retrieval speed across database size, with competitive performance across multiple benchmarks. With additional re-ranking, GENIUS often achieves results close to those of embedding-based methods while preserving efficiency.

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.

Large language models (LLMs) have recently become the leading source of answers for users' questions online. Despite their ability to offer eloquent answers, their accuracy and reliability can pose a significant challenge. This is especially true for sensitive domains such as biomedicine, where there is a higher need for factually correct answers. This paper introduces a biomedical retrieval-augmented generation (RAG) system designed to enhance the reliability of generated responses. The system is based on a fine-tuned LLM for the referenced question-answering, where retrieved relevant abstracts from PubMed are passed to LLM's context as input through a prompt. Its output is an answer based on PubMed abstracts, where each statement is referenced accordingly, allowing the users to verify the answer. Our retrieval system achieves an absolute improvement of 23% compared to the PubMed search engine. Based on the manual evaluation on a small sample, our fine-tuned LLM component achieves comparable results to GPT-4 Turbo in referencing relevant abstracts. We make the dataset used to fine-tune the models and the fine-tuned models based on Mistral-7B-instruct-v0.1 and v0.2 publicly available.

The retroperitoneum hosts a variety of tumors, including rare benign and malignant types, which pose diagnostic and treatment challenges due to their infrequency and proximity to vital structures. Estimating tumor volume is difficult due to their irregular shapes, and manual segmentation is time-consuming. Automatic segmentation using U-Net and its variants, incorporating Vision Transformer (ViT) elements, has shown promising results but struggles with high computational demands. To address this, architectures like the Mamba State Space Model (SSM) and Extended Long-Short Term Memory (xLSTM) offer efficient solutions by handling long-range dependencies with lower resource consumption. This study evaluates U-Net enhancements, including CNN, ViT, Mamba, and xLSTM, on a new in-house CT dataset and a public organ segmentation dataset. The proposed ViLU-Net model integrates Vi-blocks for improved segmentation. Results highlight xLSTM's efficiency in the U-Net framework. The code is publicly accessible on GitHub.

Determining the necessity of resecting malignant polyps during colonoscopy screen is crucial for patient outcomes, yet challenging due to the time-consuming and costly nature of histopathology examination. While deep learning-based classification models have shown promise in achieving optical biopsy with endoscopic images, they often suffer from a lack of explainability. To overcome this limitation, we introduce EndoFinder, a content-based image retrieval framework to find the 'digital twin' polyp in the reference database given a newly detected polyp. The clinical semantics of the new polyp can be inferred referring to the matched ones. EndoFinder pioneers a polyp-aware image encoder that is pre-trained on a large polyp dataset in a self-supervised way, merging masked image modeling with contrastive learning. This results in a generic embedding space ready for different downstream clinical tasks based on image retrieval. We validate the framework on polyp re-identification and optical biopsy tasks, with extensive experiments demonstrating that EndoFinder not only achieves explainable diagnostics but also matches the performance of supervised classification models. EndoFinder's reliance on image retrieval has the potential to support diverse downstream decision-making tasks during real-time colonoscopy procedures.

Information retrieval involves selecting artifacts from a corpus that are most relevant to a given search query. The flavor of retrieval typically used in classical applications can be termed as homogeneous and relaxed, where queries and corpus elements are both natural language (NL) utterances (homogeneous) and the goal is to pick most relevant elements from the corpus in the Top-K, where K is large, such as 10, 25, 50 or even 100 (relaxed). Recently, retrieval is being used extensively in preparing prompts for large language models (LLMs) to enable LLMs to perform targeted tasks. These new applications of retrieval are often heterogeneous and strict -- the queries and the corpus contain different kinds of entities, such as NL and code, and there is a need for improving retrieval at Top-K for small values of K, such as K=1 or 3 or 5. Current dense retrieval techniques based on pretrained embeddings provide a general-purpose and powerful approach for retrieval, but they are oblivious to task-specific notions of similarity of heterogeneous artifacts. We introduce Adapted Dense Retrieval, a mechanism to transform embeddings to enable improved task-specific, heterogeneous and strict retrieval. Adapted Dense Retrieval works by learning a low-rank residual adaptation of the pretrained black-box embedding. We empirically validate our approach by showing improvements over the state-of-the-art general-purpose embeddings-based baseline.

Real-world medical image segmentation has tremendous long-tailed complexity of objects, among which tail conditions correlate with relatively rare diseases and are clinically significant. A trustworthy medical AI algorithm should demonstrate its effectiveness on tail conditions to avoid clinically dangerous damage in these out-of-distribution (OOD) cases. In this paper, we adopt the concept of object queries in Mask Transformers to formulate semantic segmentation as a soft cluster assignment. The queries fit the feature-level cluster centers of inliers during training. Therefore, when performing inference on a medical image in real-world scenarios, the similarity between pixels and the queries detects and localizes OOD regions. We term this OOD localization as MaxQuery. Furthermore, the foregrounds of real-world medical images, whether OOD objects or inliers, are lesions. The difference between them is less than that between the foreground and background, possibly misleading the object queries to focus redundantly on the background. Thus, we propose a query-distribution (QD) loss to enforce clear boundaries between segmentation targets and other regions at the query level, improving the inlier segmentation and OOD indication. Our proposed framework is tested on two real-world segmentation tasks, i.e., segmentation of pancreatic and liver tumors, outperforming previous state-of-the-art algorithms by an average of 7.39% on AUROC, 14.69% on AUPR, and 13.79% on FPR95 for OOD localization. On the other hand, our framework improves the performance of inlier segmentation by an average of 5.27% DSC when compared with the leading baseline nnUNet.

Existing neural ranking models follow the text matching paradigm, where document-to-query relevance is estimated through predicting the matching score. Drawing from the rich literature of classical generative retrieval models, we introduce and formalize the paradigm of deep generative retrieval models defined via the cumulative probabilities of generating query terms. This paradigm offers a grounded probabilistic view on relevance estimation while still enabling the use of modern neural architectures. In contrast to the matching paradigm, the probabilistic nature of generative rankers readily offers a fine-grained measure of uncertainty. We adopt several current neural generative models in our framework and introduce a novel generative ranker (T-PGN), which combines the encoding capacity of Transformers with the Pointer Generator Network model. We conduct an extensive set of evaluation experiments on passage retrieval, leveraging the MS MARCO Passage Re-ranking and TREC Deep Learning 2019 Passage Re-ranking collections. Our results show the significantly higher performance of the T-PGN model when compared with other generative models. Lastly, we demonstrate that exploiting the uncertainty information of deep generative rankers opens new perspectives to query/collection understanding, and significantly improves the cut-off prediction task.

While the current state-of-the-art dense retrieval models exhibit strong out-of-domain generalization, they might fail to capture nuanced domain-specific knowledge. In principle, fine-tuning these models for specialized retrieval tasks should yield higher effectiveness than relying on a one-size-fits-all model, but in practice, results can disappoint. We show that standard fine-tuning methods using an InfoNCE loss can unexpectedly degrade effectiveness rather than improve it, even for domain-specific scenarios. This holds true even when applying widely adopted techniques such as hard-negative mining and negative de-noising. To address this, we explore a training strategy that uses listwise distillation from a teacher cross-encoder, leveraging rich relevance signals to fine-tune the retriever. We further explore synthetic query generation using large language models. Through listwise distillation and training with a diverse set of queries ranging from natural user searches and factual claims to keyword-based queries, we achieve consistent effectiveness gains across multiple datasets. Our results also reveal that synthetic queries can rival human-written queries in training utility. However, we also identify limitations, particularly in the effectiveness of cross-encoder teachers as a bottleneck. We release our code and scripts to encourage further research.

Utilizing large language models (LLMs) for transforming natural language questions into SQL queries (text-to-SQL) is a promising yet challenging approach, particularly when applied to real-world databases with complex and extensive schemas. In particular, effectively incorporating data catalogs and database values for SQL generation remains an obstacle, leading to suboptimal solutions. We address this problem by proposing a new pipeline that effectively retrieves relevant data and context, selects an efficient schema, and synthesizes correct and efficient SQL queries. To increase retrieval precision, our pipeline introduces a hierarchical retrieval method leveraging model-generated keywords, locality-sensitive hashing indexing, and vector databases. Additionally, we have developed an adaptive schema pruning technique that adjusts based on the complexity of the problem and the model's context size. Our approach generalizes to both frontier proprietary models like GPT-4 and open-source models such as Llama-3-70B. Through a series of ablation studies, we demonstrate the effectiveness of each component of our pipeline and its impact on the end-to-end performance. Our method achieves new state-of-the-art performance on the cross-domain challenging BIRD dataset.

There has been a surge of interest in harnessing the reasoning capabilities of Large Language Models (LLMs) to accelerate scientific discovery. While existing approaches rely on grounding the discovery process within the relevant literature, effectiveness varies significantly with the quality and nature of the retrieved literature. We address the challenge of retrieving prior work whose concepts can inspire solutions for a given research problem, a task we define as Methodology Inspiration Retrieval (MIR). We construct a novel dataset tailored for training and evaluating retrievers on MIR, and establish baselines. To address MIR, we build the Methodology Adjacency Graph (MAG); capturing methodological lineage through citation relationships. We leverage MAG to embed an "intuitive prior" into dense retrievers for identifying patterns of methodological inspiration beyond superficial semantic similarity. This achieves significant gains of +5.4 in Recall@3 and +7.8 in Mean Average Precision (mAP) over strong baselines. Further, we adapt LLM-based re-ranking strategies to MIR, yielding additional improvements of +4.5 in Recall@3 and +4.8 in mAP. Through extensive ablation studies and qualitative analyses, we exhibit the promise of MIR in enhancing automated scientific discovery and outline avenues for advancing inspiration-driven retrieval.

While holding great promise for improving and facilitating healthcare, large language models (LLMs) struggle to produce up-to-date responses on evolving topics due to outdated knowledge or hallucination. Retrieval-augmented generation (RAG) is a pivotal innovation that improves the accuracy and relevance of LLM responses by integrating LLMs with a search engine and external sources of knowledge. However, the quality of RAG responses can be largely impacted by the rank and density of key information in the retrieval results, such as the "lost-in-the-middle" problem. In this work, we aim to improve the robustness and reliability of the RAG workflow in the medical domain. Specifically, we propose a map-reduce strategy, BriefContext, to combat the "lost-in-the-middle" issue without modifying the model weights. We demonstrated the advantage of the workflow with various LLM backbones and on multiple QA datasets. This method promises to improve the safety and reliability of LLMs deployed in healthcare domains.

Legal Case Retrieval (LCR), which retrieves relevant cases from a query case, is a fundamental task for legal professionals in research and decision-making. However, existing studies on LCR face two major limitations. First, they are evaluated on relatively small-scale retrieval corpora (e.g., 100-55K cases) and use a narrow range of criminal query types, which cannot sufficiently reflect the complexity of real-world legal retrieval scenarios. Second, their reliance on embedding-based or lexical matching methods often results in limited representations and legally irrelevant matches. To address these issues, we present: (1) LEGAR BENCH, the first large-scale Korean LCR benchmark, covering 411 diverse crime types in queries over 1.2M legal cases; and (2) LegalSearchLM, a retrieval model that performs legal element reasoning over the query case and directly generates content grounded in the target cases through constrained decoding. Experimental results show that LegalSearchLM outperforms baselines by 6-20% on LEGAR BENCH, achieving state-of-the-art performance. It also demonstrates strong generalization to out-of-domain cases, outperforming naive generative models trained on in-domain data by 15%.

Text-to-image retrieval is a critical task for managing diverse visual content, but common benchmarks for the task rely on small, single-domain datasets that fail to capture real-world complexity. Pre-trained vision-language models tend to perform well with easy negatives but struggle with hard negatives--visually similar yet incorrect images--especially in open-domain scenarios. To address this, we introduce Episodic Few-Shot Adaptation (EFSA), a novel test-time framework that adapts pre-trained models dynamically to a query's domain by fine-tuning on top-k retrieved candidates and synthetic captions generated for them. EFSA improves performance across diverse domains while preserving generalization, as shown in evaluations on queries from eight highly distinct visual domains and an open-domain retrieval pool of over one million images. Our work highlights the potential of episodic few-shot adaptation to enhance robustness in the critical and understudied task of open-domain text-to-image retrieval.

Recent advancements in large language models (LLMs) have driven interest in billion-scale retrieval models with strong generalization across retrieval tasks and languages. Additionally, progress in large vision-language models has created new opportunities for multimodal retrieval. In response, we have updated the Tevatron toolkit, introducing a unified pipeline that enables researchers to explore retriever models at different scales, across multiple languages, and with various modalities. This demo paper highlights the toolkit's key features, bridging academia and industry by supporting efficient training, inference, and evaluation of neural retrievers. We showcase a unified dense retriever achieving strong multilingual and multimodal effectiveness, and conduct a cross-modality zero-shot study to demonstrate its research potential. Alongside, we release OmniEmbed, to the best of our knowledge, the first embedding model that unifies text, image document, video, and audio retrieval, serving as a baseline for future research.

Retrieving relevant contexts from a large corpus is a crucial step for tasks such as open-domain question answering and fact checking. Although neural retrieval outperforms traditional methods like tf-idf and BM25, its performance degrades considerably when applied to out-of-domain data. Driven by the question of whether a neural retrieval model can be universal and perform robustly on a wide variety of problems, we propose a multi-task trained model. Our approach not only outperforms previous methods in the few-shot setting, but also rivals specialised neural retrievers, even when in-domain training data is abundant. With the help of our retriever, we improve existing models for downstream tasks and closely match or improve the state of the art on multiple benchmarks.

With the rapid advancement of multimodal information retrieval, increasingly complex retrieval tasks have emerged. Existing methods predominately rely on task-specific fine-tuning of vision-language models, often those trained with image-text contrastive learning. In this paper, we explore the possibility of re-purposing generative Large Multimodal Models (LMMs) for retrieval. This approach enables unifying all retrieval tasks under the same formulation and, more importantly, allows for extrapolation towards unseen retrieval tasks without additional training. Our contributions can be summarised in the following aspects: (i) We introduce LamRA, a versatile framework designed to empower LMMs with sophisticated retrieval and reranking capabilities. (ii) For retrieval, we adopt a two-stage training strategy comprising language-only pre-training and multimodal instruction tuning to progressively enhance LMM's retrieval performance. (iii) For reranking, we employ joint training for both pointwise and listwise reranking, offering two distinct ways to further boost the retrieval performance. (iv) Extensive experimental results underscore the efficacy of our method in handling more than ten retrieval tasks, demonstrating robust performance in both supervised and zero-shot settings, including scenarios involving previously unseen retrieval tasks.

This paper proposes a Question-Answering (QA) system for the telecom domain using 3rd Generation Partnership Project (3GPP) technical documents. Alongside, a hybrid dataset, Telco-DPR, which consists of a curated 3GPP corpus in a hybrid format, combining text and tables, is presented. Additionally, the dataset includes a set of synthetic question/answer pairs designed to evaluate the retrieval performance of QA systems on this type of data. The retrieval models, including the sparse model, Best Matching 25 (BM25), as well as dense models, such as Dense Passage Retriever (DPR) and Dense Hierarchical Retrieval (DHR), are evaluated and compared using top-K accuracy and Mean Reciprocal Rank (MRR). The results show that DHR, a retriever model utilising hierarchical passage selection through fine-tuning at both the document and passage levels, outperforms traditional methods in retrieving relevant technical information, achieving a Top-10 accuracy of 86.2%. Additionally, the Retriever-Augmented Generation (RAG) technique, used in the proposed QA system, is evaluated to demonstrate the benefits of using the hybrid dataset and the DHR. The proposed QA system, using the developed RAG model and the Generative Pretrained Transformer (GPT)-4, achieves a 14% improvement in answer accuracy, when compared to a previous benchmark on the same dataset.

Although existing neural retrieval models reveal promising results when training data is abundant and the performance keeps improving as training data increases, collecting high-quality annotated data is prohibitively costly. To this end, we introduce a novel noisy self-training framework combined with synthetic queries, showing that neural retrievers can be improved in a self-evolution manner with no reliance on any external models. Experimental results show that our method improves consistently over existing methods on both general-domain (e.g., MS-MARCO) and out-of-domain (i.e., BEIR) retrieval benchmarks. Extra analysis on low-resource settings reveals that our method is data efficient and outperforms competitive baselines, with as little as 30% of labelled training data. Further extending the framework for reranker training demonstrates that the proposed method is general and yields additional gains on tasks of diverse domains.Source code is available at \url{https://github.com/Fantabulous-J/Self-Training-DPR}

Retrieval-augmented generation (RAG) is a well-suited technique for retrieving privacy-sensitive Electronic Health Records (EHR). It can serve as a key module of the healthcare copilot, helping reduce misdiagnosis for healthcare practitioners and patients. However, the diagnostic accuracy and specificity of existing heuristic-based RAG models used in the medical domain are inadequate, particularly for diseases with similar manifestations. This paper proposes MedRAG, a RAG model enhanced by knowledge graph (KG)-elicited reasoning for the medical domain that retrieves diagnosis and treatment recommendations based on manifestations. MedRAG systematically constructs a comprehensive four-tier hierarchical diagnostic KG encompassing critical diagnostic differences of various diseases. These differences are dynamically integrated with similar EHRs retrieved from an EHR database, and reasoned within a large language model. This process enables more accurate and specific decision support, while also proactively providing follow-up questions to enhance personalized medical decision-making. MedRAG is evaluated on both a public dataset DDXPlus and a private chronic pain diagnostic dataset (CPDD) collected from Tan Tock Seng Hospital, and its performance is compared against various existing RAG methods. Experimental results show that, leveraging the information integration and relational abilities of the KG, our MedRAG provides more specific diagnostic insights and outperforms state-of-the-art models in reducing misdiagnosis rates. Our code will be available at https://github.com/SNOWTEAM2023/MedRAG

Conducting text retrieval in a dense learned representation space has many intriguing advantages over sparse retrieval. Yet the effectiveness of dense retrieval (DR) often requires combination with sparse retrieval. In this paper, we identify that the main bottleneck is in the training mechanisms, where the negative instances used in training are not representative of the irrelevant documents in testing. This paper presents Approximate nearest neighbor Negative Contrastive Estimation (ANCE), a training mechanism that constructs negatives from an Approximate Nearest Neighbor (ANN) index of the corpus, which is parallelly updated with the learning process to select more realistic negative training instances. This fundamentally resolves the discrepancy between the data distribution used in the training and testing of DR. In our experiments, ANCE boosts the BERT-Siamese DR model to outperform all competitive dense and sparse retrieval baselines. It nearly matches the accuracy of sparse-retrieval-and-BERT-reranking using dot-product in the ANCE-learned representation space and provides almost 100x speed-up.

Multimodal learning significantly benefits cancer survival prediction, especially the integration of pathological images and genomic data. Despite advantages of multimodal learning for cancer survival prediction, massive redundancy in multimodal data prevents it from extracting discriminative and compact information: (1) An extensive amount of intra-modal task-unrelated information blurs discriminability, especially for gigapixel whole slide images (WSIs) with many patches in pathology and thousands of pathways in genomic data, leading to an ``intra-modal redundancy" issue. (2) Duplicated information among modalities dominates the representation of multimodal data, which makes modality-specific information prone to being ignored, resulting in an ``inter-modal redundancy" issue. To address these, we propose a new framework, Prototypical Information Bottlenecking and Disentangling (PIBD), consisting of Prototypical Information Bottleneck (PIB) module for intra-modal redundancy and Prototypical Information Disentanglement (PID) module for inter-modal redundancy. Specifically, a variant of information bottleneck, PIB, is proposed to model prototypes approximating a bunch of instances for different risk levels, which can be used for selection of discriminative instances within modality. PID module decouples entangled multimodal data into compact distinct components: modality-common and modality-specific knowledge, under the guidance of the joint prototypical distribution. Extensive experiments on five cancer benchmark datasets demonstrated our superiority over other methods.

This study presents a question-based knowledge encoding approach that improves retrieval-augmented generation (RAG) systems without requiring fine-tuning or traditional chunking. We encode textual content using generated questions that span the lexical and semantic space, creating targeted retrieval cues combined with a custom syntactic reranking method. In single-hop retrieval over 109 scientific papers, our approach achieves a Recall@3 of 0.84, outperforming traditional chunking methods by 60 percent. We also introduce "paper-cards", concise paper summaries under 300 characters, which enhance BM25 retrieval, increasing MRR@3 from 0.56 to 0.85 on simplified technical queries. For multihop tasks, our reranking method reaches an F1 score of 0.52 with LLaMA2-Chat-7B on the LongBench 2WikiMultihopQA dataset, surpassing chunking and fine-tuned baselines which score 0.328 and 0.412 respectively. This method eliminates fine-tuning requirements, reduces retrieval latency, enables intuitive question-driven knowledge access, and decreases vector storage demands by 80%, positioning it as a scalable and efficient RAG alternative.

Retrieval-Augmented Generation (RAG) systems typically rely on a single fixed retriever, despite growing evidence that no single retriever performs optimally across all query types. In this paper, we explore a query routing approach that dynamically selects from a pool of retrievers based on the query, using both train-free heuristics and learned routing models. We frame routing as a learning-to-rank (LTR) problem and introduce LTRR, a framework that learns to rank retrievers by their expected utility gain to downstream LLM performance. Our experiments, conducted on synthetic QA data with controlled query type variations, show that routing-based RAG systems can outperform the best single-retriever-based systems. Performance gains are especially pronounced in models trained with the Answer Correctness (AC) metric and with pairwise learning approaches, especially with XGBoost. We also observe improvements in generalization to out-of-distribution queries. As part of the SIGIR 2025 LiveRAG challenge, our submitted system demonstrated the practical viability of our approach, achieving competitive performance in both answer correctness and faithfulness. These findings highlight the importance of both training methodology and metric selection in query routing for RAG systems.

Background: Recent advancements in large language models (LLMs) offer potential benefits in healthcare, particularly in processing extensive patient records. However, existing benchmarks do not fully assess LLMs' capability in handling real-world, lengthy clinical data. Methods: We present the LongHealth benchmark, comprising 20 detailed fictional patient cases across various diseases, with each case containing 5,090 to 6,754 words. The benchmark challenges LLMs with 400 multiple-choice questions in three categories: information extraction, negation, and sorting, challenging LLMs to extract and interpret information from large clinical documents. Results: We evaluated nine open-source LLMs with a minimum of 16,000 tokens and also included OpenAI's proprietary and cost-efficient GPT-3.5 Turbo for comparison. The highest accuracy was observed for Mixtral-8x7B-Instruct-v0.1, particularly in tasks focused on information retrieval from single and multiple patient documents. However, all models struggled significantly in tasks requiring the identification of missing information, highlighting a critical area for improvement in clinical data interpretation. Conclusion: While LLMs show considerable potential for processing long clinical documents, their current accuracy levels are insufficient for reliable clinical use, especially in scenarios requiring the identification of missing information. The LongHealth benchmark provides a more realistic assessment of LLMs in a healthcare setting and highlights the need for further model refinement for safe and effective clinical application. We make the benchmark and evaluation code publicly available.

Semantic retrieval is crucial for modern applications yet remains underexplored in current research. Existing datasets are limited to single languages, single images, or singular retrieval conditions, often failing to fully exploit the expressive capacity of visual information as evidenced by maintained performance when images are replaced with captions. However, practical retrieval scenarios frequently involve interleaved multi-condition queries with multiple images. Hence, this paper introduces MERIT, the first multilingual dataset for interleaved multi-condition semantic retrieval, comprising 320,000 queries with 135,000 products in 5 languages, covering 7 distinct product categories. Extensive experiments on MERIT identify existing models's limitation: focusing solely on global semantic information while neglecting specific conditional elements in queries. Consequently, we propose Coral, a novel fine-tuning framework that adapts pre-trained MLLMs by integrating embedding reconstruction to preserve fine-grained conditional elements and contrastive learning to extract comprehensive global semantics. Experiments demonstrate that Coral achieves a 45.9% performance improvement over conventional approaches on MERIT, with strong generalization capabilities validated across 8 established retrieval benchmarks. Collectively, our contributions - a novel dataset, identification of critical limitations in existing approaches, and an innovative fine-tuning framework - establish a foundation for future research in interleaved multi-condition semantic retrieval.

Recent advancements in dense retrieval have introduced vision-language model (VLM)-based retrievers, such as DSE and ColPali, which leverage document screenshots embedded as vectors to enable effective search and offer a simplified pipeline over traditional text-only methods. In this study, we propose three pixel poisoning attack methods designed to compromise VLM-based retrievers and evaluate their effectiveness under various attack settings and parameter configurations. Our empirical results demonstrate that injecting even a single adversarial screenshot into the retrieval corpus can significantly disrupt search results, poisoning the top-10 retrieved documents for 41.9% of queries in the case of DSE and 26.4% for ColPali. These vulnerability rates notably exceed those observed with equivalent attacks on text-only retrievers. Moreover, when targeting a small set of known queries, the attack success rate raises, achieving complete success in certain cases. By exposing the vulnerabilities inherent in vision-language models, this work highlights the potential risks associated with their deployment.

Recently, deep learning-based language models have significantly enhanced text-to-SQL tasks, with promising applications in retrieving patient records within the medical domain. One notable challenge in such applications is discerning unanswerable queries. Through fine-tuning model, we demonstrate the feasibility of converting medical record inquiries into SQL queries. Additionally, we introduce an entropy-based method to identify and filter out unanswerable results. We further enhance result quality by filtering low-confidence SQL through log probability-based distribution, while grammatical and schema errors are mitigated by executing queries on the actual database. We experimentally verified that our method can filter unanswerable questions, which can be widely utilized even when the parameters of the model are not accessible, and that it can be effectively utilized in practice.

Retrieval-Augmented Generation (RAG) has become ubiquitous when deploying Large Language Models (LLMs), as it can address typical limitations such as generating hallucinated or outdated information. However, when building real-world RAG applications, practical issues arise. First, the retrieved information is generally domain-specific. Since it is computationally expensive to fine-tune LLMs, it is more feasible to fine-tune the retriever to improve the quality of the data included in the LLM input. Second, as more applications are deployed in the same real-world system, one cannot afford to deploy separate retrievers. Moreover, these RAG applications normally retrieve different kinds of data. Our solution is to instruction fine-tune a small retriever encoder on a variety of domain-specific tasks to allow us to deploy one encoder that can serve many use cases, thereby achieving low-cost, scalability, and speed. We show how this encoder generalizes to out-of-domain settings as well as to an unseen retrieval task on real-world enterprise use cases.

Text retrieval is a long-standing research topic on information seeking, where a system is required to return relevant information resources to user's queries in natural language. From classic retrieval methods to learning-based ranking functions, the underlying retrieval models have been continually evolved with the ever-lasting technical innovation. To design effective retrieval models, a key point lies in how to learn the text representation and model the relevance matching. The recent success of pretrained language models (PLMs) sheds light on developing more capable text retrieval approaches by leveraging the excellent modeling capacity of PLMs. With powerful PLMs, we can effectively learn the representations of queries and texts in the latent representation space, and further construct the semantic matching function between the dense vectors for relevance modeling. Such a retrieval approach is referred to as dense retrieval, since it employs dense vectors (a.k.a., embeddings) to represent the texts. Considering the rapid progress on dense retrieval, in this survey, we systematically review the recent advances on PLM-based dense retrieval. Different from previous surveys on dense retrieval, we take a new perspective to organize the related work by four major aspects, including architecture, training, indexing and integration, and summarize the mainstream techniques for each aspect. We thoroughly survey the literature, and include 300+ related reference papers on dense retrieval. To support our survey, we create a website for providing useful resources, and release a code repertory and toolkit for implementing dense retrieval models. This survey aims to provide a comprehensive, practical reference focused on the major progress for dense text retrieval.

Large Language Model-based Dense Retrieval (LLM-DR) optimizes over numerous heterogeneous fine-tuning collections from different domains. However, the discussion about its training data distribution is still minimal. Previous studies rely on empirically assigned dataset choices or sampling ratios, which inevitably leads to sub-optimal retrieval performances. In this paper, we propose a new task-level Distributionally Robust Optimization (tDRO) algorithm for LLM-DR fine-tuning, targeted at improving the universal domain generalization ability by end-to-end reweighting the data distribution of each task. The tDRO parameterizes the domain weights and updates them with scaled domain gradients. The optimized weights are then transferred to the LLM-DR fine-tuning to train more robust retrievers. Experiments show optimal improvements in large-scale retrieval benchmarks and reduce up to 30% dataset usage after applying our optimization algorithm with a series of different-sized LLM-DR models.

In neural Information Retrieval (IR), ongoing research is directed towards improving the first retriever in ranking pipelines. Learning dense embeddings to conduct retrieval using efficient approximate nearest neighbors methods has proven to work well. Meanwhile, there has been a growing interest in learning sparse representations for documents and queries, that could inherit from the desirable properties of bag-of-words models such as the exact matching of terms and the efficiency of inverted indexes. Introduced recently, the SPLADE model provides highly sparse representations and competitive results with respect to state-of-the-art dense and sparse approaches. In this paper, we build on SPLADE and propose several significant improvements in terms of effectiveness and/or efficiency. More specifically, we modify the pooling mechanism, benchmark a model solely based on document expansion, and introduce models trained with distillation. We also report results on the BEIR benchmark. Overall, SPLADE is considerably improved with more than 9\% gains on NDCG@10 on TREC DL 2019, leading to state-of-the-art results on the BEIR benchmark.

In neural Information Retrieval, ongoing research is directed towards improving the first retriever in ranking pipelines. Learning dense embeddings to conduct retrieval using efficient approximate nearest neighbors methods has proven to work well. Meanwhile, there has been a growing interest in learning sparse representations for documents and queries, that could inherit from the desirable properties of bag-of-words models such as the exact matching of terms and the efficiency of inverted indexes. In this work, we present a new first-stage ranker based on explicit sparsity regularization and a log-saturation effect on term weights, leading to highly sparse representations and competitive results with respect to state-of-the-art dense and sparse methods. Our approach is simple, trained end-to-end in a single stage. We also explore the trade-off between effectiveness and efficiency, by controlling the contribution of the sparsity regularization.

Large Language Models (LLMs) are prone to generating factually incorrect information when responding to queries that involve numerical and statistical data or other timely facts. In this paper, we present an approach for enhancing the accuracy of LLMs by integrating them with Data Commons, a vast, open-source repository of public statistics from trusted organizations like the United Nations (UN), Center for Disease Control and Prevention (CDC) and global census bureaus. We explore two primary methods: Retrieval Interleaved Generation (RIG), where the LLM is trained to produce natural language queries to retrieve data from Data Commons, and Retrieval Augmented Generation (RAG), where relevant data tables are fetched from Data Commons and used to augment the LLM's prompt. We evaluate these methods on a diverse set of queries, demonstrating their effectiveness in improving the factual accuracy of LLM outputs. Our work represents an early step towards building more trustworthy and reliable LLMs that are grounded in verifiable statistical data and capable of complex factual reasoning.

A key component of fact verification is thevevidence retrieval, often from multiple documents. Recent approaches use dense representations and condition the retrieval of each document on the previously retrieved ones. The latter step is performed over all the documents in the collection, requiring storing their dense representations in an index, thus incurring a high memory footprint. An alternative paradigm is retrieve-and-rerank, where documents are retrieved using methods such as BM25, their sentences are reranked, and further documents are retrieved conditioned on these sentences, reducing the memory requirements. However, such approaches can be brittle as they rely on heuristics and assume hyperlinks between documents. We propose a novel retrieve-and-rerank method for multi-hop retrieval, that consists of a retriever that jointly scores documents in the knowledge source and sentences from previously retrieved documents using an autoregressive formulation and is guided by a proof system based on natural logic that dynamically terminates the retrieval process if the evidence is deemed sufficient. This method is competitive with current state-of-the-art methods on FEVER, HoVer and FEVEROUS-S, while using 5 to 10 times less memory than competing systems. Evaluation on an adversarial dataset indicates improved stability of our approach compared to commonly deployed threshold-based methods. Finally, the proof system helps humans predict model decisions correctly more often than using the evidence alone.

Accurate prostate cancer diagnosis remains challenging. Even when using MRI, radiologists exhibit low specificity and significant inter-observer variability, leading to potential delays or inaccuracies in identifying clinically significant cancers. This leads to numerous unnecessary biopsies and risks of missing clinically significant cancers. Here we present prostate vision contrastive network (ProViCNet), prostate organ-specific vision foundation models for Magnetic Resonance Imaging (MRI) and Trans-Rectal Ultrasound imaging (TRUS) for comprehensive cancer detection. ProViCNet was trained and validated using 4,401 patients across six institutions, as a prostate cancer detection model on radiology images relying on patch-level contrastive learning guided by biopsy confirmed radiologist annotations. ProViCNet demonstrated consistent performance across multiple internal and external validation cohorts with area under the receiver operating curve values ranging from 0.875 to 0.966, significantly outperforming radiologists in the reader study (0.907 versus 0.805, p<0.001) for mpMRI, while achieving 0.670 to 0.740 for TRUS. We also integrated ProViCNet with standard PSA to develop a virtual screening test, and we showed that we can maintain the high sensitivity for detecting clinically significant cancers while more than doubling specificity from 15% to 38% (p<0.001), thereby substantially reducing unnecessary biopsies. These findings highlight that ProViCNet's potential for enhancing prostate cancer diagnosis accuracy and reduce unnecessary biopsies, thereby optimizing diagnostic pathways.

Adaptive retrieval-augmented generation (ARAG) aims to dynamically determine the necessity of retrieval for queries instead of retrieving indiscriminately to enhance the efficiency and relevance of the sourced information. However, previous works largely overlook the evaluation of ARAG approaches, leading to their effectiveness being understudied. This work presents a benchmark, RetrievalQA, comprising 1,271 short-form questions covering new world and long-tail knowledge. The knowledge necessary to answer the questions is absent from LLMs; therefore, external information must be retrieved to answer correctly. This makes RetrievalQA a suitable testbed to evaluate existing ARAG methods. We observe that calibration-based methods heavily rely on threshold tuning, while vanilla prompting is inadequate for guiding LLMs to make reliable retrieval decisions. Based on our findings, we propose Time-Aware Adaptive Retrieval (TA-ARE), a simple yet effective method that helps LLMs assess the necessity of retrieval without calibration or additional training. The dataset and code will be available at https://github.com/hyintell/RetrievalQA

One technique to improve the retrieval effectiveness of a search engine is to expand documents with terms that are related or representative of the documents' content.From the perspective of a question answering system, this might comprise questions the document can potentially answer. Following this observation, we propose a simple method that predicts which queries will be issued for a given document and then expands it with those predictions with a vanilla sequence-to-sequence model, trained using datasets consisting of pairs of query and relevant documents. By combining our method with a highly-effective re-ranking component, we achieve the state of the art in two retrieval tasks. In a latency-critical regime, retrieval results alone (without re-ranking) approach the effectiveness of more computationally expensive neural re-rankers but are much faster.

Text-to-image generation increasingly demands access to domain-specific, fine-grained, and rapidly evolving knowledge that pretrained models cannot fully capture. Existing Retrieval-Augmented Generation (RAG) methods attempt to address this by retrieving globally relevant images, but they fail when no single image contains all desired elements from a complex user query. We propose Cross-modal RAG, a novel framework that decomposes both queries and images into sub-dimensional components, enabling subquery-aware retrieval and generation. Our method introduces a hybrid retrieval strategy - combining a sub-dimensional sparse retriever with a dense retriever - to identify a Pareto-optimal set of images, each contributing complementary aspects of the query. During generation, a multimodal large language model is guided to selectively condition on relevant visual features aligned to specific subqueries, ensuring subquery-aware image synthesis. Extensive experiments on MS-COCO, Flickr30K, WikiArt, CUB, and ImageNet-LT demonstrate that Cross-modal RAG significantly outperforms existing baselines in both retrieval and generation quality, while maintaining high efficiency.

Multimodal pathology-genomic analysis is critical for cancer survival prediction. However, existing approaches predominantly integrate formalin-fixed paraffin-embedded (FFPE) slides with genomic data, while neglecting the availability of other preservation slides, such as Fresh Froze (FF) slides. Moreover, as the high-resolution spatial nature of pathology data tends to dominate the cross-modality fusion process, it hinders effective multimodal fusion and leads to modality imbalance challenges between pathology and genomics. These methods also typically require complete data modalities, limiting their clinical applicability with incomplete modalities, such as missing either pathology or genomic data. In this paper, we propose a multimodal survival prediction framework that leverages hypergraph learning to effectively integrate multi-WSI information and cross-modality interactions between pathology slides and genomics data while addressing modality imbalance. In addition, we introduce a memory mechanism that stores previously learned paired pathology-genomic features and dynamically compensates for incomplete modalities. Experiments on five TCGA datasets demonstrate that our model outperforms advanced methods by over 2.3% in C-Index. Under incomplete modality scenarios, our approach surpasses pathology-only (3.3%) and gene-only models (7.9%). Code: https://github.com/MCPathology/M2Surv

With an estimated 160,000 deaths in 2018, lung cancer is the most common cause of cancer death in the United States. Lung cancer CT screening has been shown to reduce mortality by up to 40% and is now included in US screening guidelines. Reducing the high error rates in lung cancer screening is imperative because of the high clinical and financial costs caused by diagnosis mistakes. Despite the use of standards for radiological diagnosis, persistent inter-grader variability and incomplete characterization of comprehensive imaging findings remain as limitations of current methods. These limitations suggest opportunities for more sophisticated systems to improve performance and inter-reader consistency. In this report, we reproduce a state-of-the-art deep learning algorithm for lung cancer risk prediction. Our model predicts malignancy probability and risk bucket classification from lung CT studies. This allows for risk categorization of patients being screened and suggests the most appropriate surveillance and management. Combining our solution high accuracy, consistency and fully automated nature, our approach may enable highly efficient screening procedures and accelerate the adoption of lung cancer screening.

Retrieval-Augmented Generation (RAG) has shown substantial promise in improving factual accuracy by grounding model responses with external knowledge relevant to queries. However, most existing RAG approaches are limited to a text-only corpus, and while recent efforts have extended RAG to other modalities such as images and videos, they typically operate over a single modality-specific corpus. In contrast, real-world queries vary widely in the type of knowledge they require, which a single type of knowledge source cannot address. To address this, we introduce UniversalRAG, a novel RAG framework designed to retrieve and integrate knowledge from heterogeneous sources with diverse modalities and granularities. Specifically, motivated by the observation that forcing all modalities into a unified representation space derived from a single combined corpus causes a modality gap, where the retrieval tends to favor items from the same modality as the query, we propose a modality-aware routing mechanism that dynamically identifies the most appropriate modality-specific corpus and performs targeted retrieval within it. Also, beyond modality, we organize each modality into multiple granularity levels, enabling fine-tuned retrieval tailored to the complexity and scope of the query. We validate UniversalRAG on 8 benchmarks spanning multiple modalities, showing its superiority over modality-specific and unified baselines.

We consider the large-scale query-document retrieval problem: given a query (e.g., a question), return the set of relevant documents (e.g., paragraphs containing the answer) from a large document corpus. This problem is often solved in two steps. The retrieval phase first reduces the solution space, returning a subset of candidate documents. The scoring phase then re-ranks the documents. Critically, the retrieval algorithm not only desires high recall but also requires to be highly efficient, returning candidates in time sublinear to the number of documents. Unlike the scoring phase witnessing significant advances recently due to the BERT-style pre-training tasks on cross-attention models, the retrieval phase remains less well studied. Most previous works rely on classic Information Retrieval (IR) methods such as BM-25 (token matching + TF-IDF weights). These models only accept sparse handcrafted features and can not be optimized for different downstream tasks of interest. In this paper, we conduct a comprehensive study on the embedding-based retrieval models. We show that the key ingredient of learning a strong embedding-based Transformer model is the set of pre-training tasks. With adequately designed paragraph-level pre-training tasks, the Transformer models can remarkably improve over the widely-used BM-25 as well as embedding models without Transformers. The paragraph-level pre-training tasks we studied are Inverse Cloze Task (ICT), Body First Selection (BFS), Wiki Link Prediction (WLP), and the combination of all three.

Universal multimodal retrieval (UMR), which aims to address complex retrieval tasks where both queries and candidates span diverse modalities, has been significantly advanced by the emergence of MLLMs. While state-of-the-art MLLM-based methods in the literature predominantly adopt contrastive learning principles, they often differ in their specific training recipes. Despite their success, the mechanisms underlying their retrieval capabilities remain largely unexplored, potentially resulting in suboptimal performance and limited generalization ability. To address these issues, we present a comprehensive study aimed at uncovering the key factors that drive effective embedding learning for UMR using MLLMs. We begin by implementing a general MLLM-based embedding learning pipeline, and systematically analyze the primary contributors to high-performing universal retrieval systems. Based on this, we explore various aspects of the details in embedding generation and training strategies, including progressive transition, hard negative mining and re-ranker distillation. Notably, our findings reveal that often-overlooked factors can have a substantial impact on model performance. Building on these discoveries, we introduce a unified framework termed U-MARVEL (Universal MultimodAl RetrieVal via Embedding Learning), which outperforms state-of-the-art competitors on the M-BEIR benchmark by a large margin in supervised settings, and also exihibits strong zero-shot performance on several tasks such as composed image retrieval and text-to-video retrieval. These results underscore the generalization potential of our framework across various embedding-based retrieval tasks. Code is available at https://github.com/chaxjli/U-MARVEL

Learned sparse text embeddings have gained popularity due to their effectiveness in top-k retrieval and inherent interpretability. Their distributional idiosyncrasies, however, have long hindered their use in real-world retrieval systems. That changed with the recent development of approximate algorithms that leverage the distributional properties of sparse embeddings to speed up retrieval. Nonetheless, in much of the existing literature, evaluation has been limited to datasets with only a few million documents such as MSMARCO. It remains unclear how these systems behave on much larger datasets and what challenges lurk in larger scales. To bridge that gap, we investigate the behavior of state-of-the-art retrieval algorithms on massive datasets. We compare and contrast the recently-proposed Seismic and graph-based solutions adapted from dense retrieval. We extensively evaluate Splade embeddings of 138M passages from MsMarco-v2 and report indexing time and other efficiency and effectiveness metrics.

The landscape of information retrieval has broadened from search services to a critical component in various advanced applications, where indexing efficiency, cost-effectiveness, and freshness are increasingly important yet remain less explored. To address these demands, we introduce Semi-parametric Vocabulary Disentangled Retrieval (SVDR). SVDR is a novel semi-parametric retrieval framework that supports two types of indexes: an embedding-based index for high effectiveness, akin to existing neural retrieval methods; and a binary token index that allows for quick and cost-effective setup, resembling traditional term-based retrieval. In our evaluation on three open-domain question answering benchmarks with the entire Wikipedia as the retrieval corpus, SVDR consistently demonstrates superiority. It achieves a 3% higher top-1 retrieval accuracy compared to the dense retriever DPR when using an embedding-based index and an 9% higher top-1 accuracy compared to BM25 when using a binary token index. Specifically, the adoption of a binary token index reduces index preparation time from 30 GPU hours to just 2 CPU hours and storage size from 31 GB to 2 GB, achieving a 90% reduction compared to an embedding-based index.

Extraction of relevant pathological terms from radiology reports is important for correct image label generation and disease population studies. In this letter, we compare the performance of some known application program interface (APIs) for the task of thoracic abnormality extraction from radiology reports. We explored several medical domain specific annotation tools like Medical Text Indexer(MTI) with Non-MEDLINE and Mesh On Demand(MOD) options and generic Natural Language Understanding (NLU) API provided by the IBM cloud. Our results show that although MTI and MOD are intended for extracting medical terms, their performance is worst compared to generic extraction API like IBM NLU. Finally, we trained a DNN-based Named Entity Recognition (NER) model to extract the key concept words from radiology reports. Our model outperforms the medical specific and generic API performance by a large margin. Our results demonstrate the inadequacy of generic APIs for pathology extraction task and establish the importance of domain specific model training for improved results. We hope that these results motivate the research community to release larger de-identified radiology reports corpus for building high accuracy machine learning models for the important task of pathology extraction.

Retrieval-augmented generation (RAG) has shown impressive capability in providing reliable answer predictions and addressing hallucination problems. A typical RAG implementation uses powerful retrieval models to extract external information and large language models (LLMs) to generate answers. In contrast, recent LLM-based retrieval has gained attention for its substantial improvements in information retrieval (IR) due to the LLMs' semantic understanding capability. However, directly applying LLM to RAG systems presents challenges. This may cause feature locality problems as massive parametric knowledge can hinder effective usage of global information across the corpus; for example, an LLM-based retriever often inputs document summaries instead of full documents. Moreover, various pre-trained tasks in LLMs introduce variance, further weakening performance as a retriever. To address these issues, we propose a novel two-stage fine-tuning architecture called Invar-RAG. In the retrieval stage, an LLM-based retriever is constructed by integrating LoRA-based representation learning to tackle feature locality issues. To enhance retrieval performance, we develop two patterns (invariant and variant patterns) and an invariance loss to reduce LLM variance. In the generation stage, a refined fine-tuning method is employed to improve LLM accuracy in generating answers based on retrieved information. Experimental results show that Invar-RAG significantly outperforms existing baselines across three open-domain question answering (ODQA) datasets. Code is available in the Supplementary Material for reproducibility.

In this paper, we introduce MultiConIR, the first benchmark designed to evaluate retrieval models in multi-condition scenarios. Unlike existing datasets that primarily focus on single-condition queries from search engines, MultiConIR captures real-world complexity by incorporating five diverse domains: books, movies, people, medical cases, and legal documents. We propose three tasks to systematically assess retrieval and reranking models on multi-condition robustness, monotonic relevance ranking, and query format sensitivity. Our findings reveal that existing retrieval and reranking models struggle with multi-condition retrieval, with rerankers suffering severe performance degradation as query complexity increases. We further investigate the performance gap between retrieval and reranking models, exploring potential reasons for these discrepancies, and analysis the impact of different pooling strategies on condition placement sensitivity. Finally, we highlight the strengths of GritLM and Nv-Embed, which demonstrate enhanced adaptability to multi-condition queries, offering insights for future retrieval models. The code and datasets are available at https://github.com/EIT-NLP/MultiConIR.

Large Language Models (LLMs) have demonstrated remarkable capabilities in natural language processing, and yet, their factual inaccuracies and hallucinations limits their application, particularly in critical domains like healthcare. Context retrieval methods, by introducing relevant information as input, have emerged as a crucial approach for enhancing LLM factuality and reliability. This study explores the boundaries of context retrieval methods within the healthcare domain, optimizing their components and benchmarking their performance against open and closed alternatives. Our findings reveal how open LLMs, when augmented with an optimized retrieval system, can achieve performance comparable to the biggest private solutions on established healthcare benchmarks (multiple-choice question answering). Recognizing the lack of realism of including the possible answers within the question (a setup only found in medical exams), and after assessing a strong LLM performance degradation in the absence of those options, we extend the context retrieval system in that direction. In particular, we propose OpenMedPrompt a pipeline that improves the generation of more reliable open-ended answers, moving this technology closer to practical application.

A retrieval model should not only interpolate the training data but also extrapolate well to the queries that are different from the training data. While neural retrieval models have demonstrated impressive performance on ad-hoc search benchmarks, we still know little about how they perform in terms of interpolation and extrapolation. In this paper, we demonstrate the importance of separately evaluating the two capabilities of neural retrieval models. Firstly, we examine existing ad-hoc search benchmarks from the two perspectives. We investigate the distribution of training and test data and find a considerable overlap in query entities, query intent, and relevance labels. This finding implies that the evaluation on these test sets is biased toward interpolation and cannot accurately reflect the extrapolation capacity. Secondly, we propose a novel evaluation protocol to separately evaluate the interpolation and extrapolation performance on existing benchmark datasets. It resamples the training and test data based on query similarity and utilizes the resampled dataset for training and evaluation. Finally, we leverage the proposed evaluation protocol to comprehensively revisit a number of widely-adopted neural retrieval models. Results show models perform differently when moving from interpolation to extrapolation. For example, representation-based retrieval models perform almost as well as interaction-based retrieval models in terms of interpolation but not extrapolation. Therefore, it is necessary to separately evaluate both interpolation and extrapolation performance and the proposed resampling method serves as a simple yet effective evaluation tool for future IR studies.

Recently, information retrieval has seen the emergence of dense retrievers, using neural networks, as an alternative to classical sparse methods based on term-frequency. These models have obtained state-of-the-art results on datasets and tasks where large training sets are available. However, they do not transfer well to new applications with no training data, and are outperformed by unsupervised term-frequency methods such as BM25. In this work, we explore the limits of contrastive learning as a way to train unsupervised dense retrievers and show that it leads to strong performance in various retrieval settings. On the BEIR benchmark our unsupervised model outperforms BM25 on 11 out of 15 datasets for the Recall@100. When used as pre-training before fine-tuning, either on a few thousands in-domain examples or on the large MS~MARCO dataset, our contrastive model leads to improvements on the BEIR benchmark. Finally, we evaluate our approach for multi-lingual retrieval, where training data is even scarcer than for English, and show that our approach leads to strong unsupervised performance. Our model also exhibits strong cross-lingual transfer when fine-tuned on supervised English data only and evaluated on low resources language such as Swahili. We show that our unsupervised models can perform cross-lingual retrieval between different scripts, such as retrieving English documents from Arabic queries, which would not be possible with term matching methods.

Retrieval-augmented generation (RAG) based large language models (LLMs) are widely used in finance for their excellent performance on knowledge-intensive tasks. However, standardized documents (e.g., SEC filing) share similar formats such as repetitive boilerplate texts, and similar table structures. This similarity forces traditional RAG methods to misidentify near-duplicate text, leading to duplicate retrieval that undermines accuracy and completeness. To address these issues, we propose the Hierarchical Retrieval with Evidence Curation (HiREC) framework. Our approach first performs hierarchical retrieval to reduce confusion among similar texts. It first retrieve related documents and then selects the most relevant passages from the documents. The evidence curation process removes irrelevant passages. When necessary, it automatically generates complementary queries to collect missing information. To evaluate our approach, we construct and release a Large-scale Open-domain Financial (LOFin) question answering benchmark that includes 145,897 SEC documents and 1,595 question-answer pairs. Our code and data are available at https://github.com/deep-over/LOFin-bench-HiREC.

The task of Prior Case Retrieval (PCR) in the legal domain is about automatically citing relevant (based on facts and precedence) prior legal cases in a given query case. To further promote research in PCR, in this paper, we propose a new large benchmark (in English) for the PCR task: IL-PCR (Indian Legal Prior Case Retrieval) corpus. Given the complex nature of case relevance and the long size of legal documents, BM25 remains a strong baseline for ranking the cited prior documents. In this work, we explore the role of events in legal case retrieval and propose an unsupervised retrieval method-based pipeline U-CREAT (Unsupervised Case Retrieval using Events Extraction). We find that the proposed unsupervised retrieval method significantly increases performance compared to BM25 and makes retrieval faster by a considerable margin, making it applicable to real-time case retrieval systems. Our proposed system is generic, we show that it generalizes across two different legal systems (Indian and Canadian), and it shows state-of-the-art performance on the benchmarks for both the legal systems (IL-PCR and COLIEE corpora).

In this paper we address issues with image retrieval benchmarking on standard and popular Oxford 5k and Paris 6k datasets. In particular, annotation errors, the size of the dataset, and the level of challenge are addressed: new annotation for both datasets is created with an extra attention to the reliability of the ground truth. Three new protocols of varying difficulty are introduced. The protocols allow fair comparison between different methods, including those using a dataset pre-processing stage. For each dataset, 15 new challenging queries are introduced. Finally, a new set of 1M hard, semi-automatically cleaned distractors is selected. An extensive comparison of the state-of-the-art methods is performed on the new benchmark. Different types of methods are evaluated, ranging from local-feature-based to modern CNN based methods. The best results are achieved by taking the best of the two worlds. Most importantly, image retrieval appears far from being solved.

Multi-stage ranking pipelines have been a practical solution in modern search systems, where the first-stage retrieval is to return a subset of candidate documents, and latter stages attempt to re-rank those candidates. Unlike re-ranking stages going through quick technique shifts during past decades, the first-stage retrieval has long been dominated by classical term-based models. Unfortunately, these models suffer from the vocabulary mismatch problem, which may block re-ranking stages from relevant documents at the very beginning. Therefore, it has been a long-term desire to build semantic models for the first-stage retrieval that can achieve high recall efficiently. Recently, we have witnessed an explosive growth of research interests on the first-stage semantic retrieval models. We believe it is the right time to survey current status, learn from existing methods, and gain some insights for future development. In this paper, we describe the current landscape of the first-stage retrieval models under a unified framework to clarify the connection between classical term-based retrieval methods, early semantic retrieval methods and neural semantic retrieval methods. Moreover, we identify some open challenges and envision some future directions, with the hope of inspiring more researches on these important yet less investigated topics.

In the information retrieval (IR) area, dense retrieval (DR) models use deep learning techniques to encode queries and passages into embedding space to compute their semantic relations. It is important for DR models to balance both efficiency and effectiveness. Pre-trained language models (PLMs), especially Transformer-based PLMs, have been proven to be effective encoders of DR models. However, the self-attention component in Transformer-based PLM results in a computational complexity that grows quadratically with sequence length, and thus exhibits a slow inference speed for long-text retrieval. Some recently proposed non-Transformer PLMs, especially the Mamba architecture PLMs, have demonstrated not only comparable effectiveness to Transformer-based PLMs on generative language tasks but also better efficiency due to linear time scaling in sequence length. This paper implements the Mamba Retriever to explore whether Mamba can serve as an effective and efficient encoder of DR model for IR tasks. We fine-tune the Mamba Retriever on the classic short-text MS MARCO passage ranking dataset and the long-text LoCoV0 dataset. Experimental results show that (1) on the MS MARCO passage ranking dataset and BEIR, the Mamba Retriever achieves comparable or better effectiveness compared to Transformer-based retrieval models, and the effectiveness grows with the size of the Mamba model; (2) on the long-text LoCoV0 dataset, the Mamba Retriever can extend to longer text length than its pre-trained length after fine-tuning on retrieval task, and it has comparable or better effectiveness compared to other long-text retrieval models; (3) the Mamba Retriever has superior inference speed for long-text retrieval. In conclusion, Mamba Retriever is both effective and efficient, making it a practical model, especially for long-text retrieval.

Contrastive Language-Image Pre-training (CLIP) demonstrates strong potential in medical image analysis but requires substantial data and computational resources. Due to these restrictions, existing CLIP applications in medical imaging focus mainly on modalities like chest X-rays that have abundant image-report data available, leaving many other important modalities underexplored. Here, we propose one of the first adaptations of the full CLIP model to mammography, which presents significant challenges due to labeled data scarcity, high-resolution images with small regions of interest, and class-wise imbalance. We first develop a specialized supervision framework for mammography that leverages its multi-view nature. Furthermore, we design a symmetric local alignment module to better focus on detailed features in high-resolution images. Lastly, we incorporate a parameter-efficient fine-tuning approach for large language models pre-trained with medical knowledge to address data limitations. Our multi-view and multi-scale alignment (MaMA) method outperforms state-of-the-art baselines for three different tasks on two large real-world mammography datasets, EMBED and RSNA-Mammo, with only 52% model size compared with the largest baseline. The code is available at https://github.com/XYPB/MaMA

Medical imaging analysis plays a critical role in the diagnosis and treatment of various medical conditions. This paper focuses on chest X-ray images and their corresponding radiological reports. It presents a new model that learns a joint X-ray image & report representation. The model is based on a novel alignment scheme between the visual data and the text, which takes into account both local and global information. Furthermore, the model integrates domain-specific information of two types -- lateral images and the consistent visual structure of chest images. Our representation is shown to benefit three types of retrieval tasks: text-image retrieval, class-based retrieval, and phrase-grounding.

Various techniques have been developed in recent years to improve dense retrieval (DR), such as unsupervised contrastive learning and pseudo-query generation. Existing DRs, however, often suffer from effectiveness tradeoffs between supervised and zero-shot retrieval, which some argue was due to the limited model capacity. We contradict this hypothesis and show that a generalizable DR can be trained to achieve high accuracy in both supervised and zero-shot retrieval without increasing model size. In particular, we systematically examine the contrastive learning of DRs, under the framework of Data Augmentation (DA). Our study shows that common DA practices such as query augmentation with generative models and pseudo-relevance label creation using a cross-encoder, are often inefficient and sub-optimal. We hence propose a new DA approach with diverse queries and sources of supervision to progressively train a generalizable DR. As a result, DRAGON, our dense retriever trained with diverse augmentation, is the first BERT-base-sized DR to achieve state-of-the-art effectiveness in both supervised and zero-shot evaluations and even competes with models using more complex late interaction (ColBERTv2 and SPLADE++).

Large language models (LLM) have demonstrated remarkable capabilities in various biomedical natural language processing (NLP) tasks, leveraging the demonstration within the input context to adapt to new tasks. However, LLM is sensitive to the selection of demonstrations. To address the hallucination issue inherent in LLM, retrieval-augmented LLM (RAL) offers a solution by retrieving pertinent information from an established database. Nonetheless, existing research work lacks rigorous evaluation of the impact of retrieval-augmented large language models on different biomedical NLP tasks. This deficiency makes it challenging to ascertain the capabilities of RAL within the biomedical domain. Moreover, the outputs from RAL are affected by retrieving the unlabeled, counterfactual, or diverse knowledge that is not well studied in the biomedical domain. However, such knowledge is common in the real world. Finally, exploring the self-awareness ability is also crucial for the RAL system. So, in this paper, we systematically investigate the impact of RALs on 5 different biomedical tasks (triple extraction, link prediction, classification, question answering, and natural language inference). We analyze the performance of RALs in four fundamental abilities, including unlabeled robustness, counterfactual robustness, diverse robustness, and negative awareness. To this end, we proposed an evaluation framework to assess the RALs' performance on different biomedical NLP tasks and establish four different testbeds based on the aforementioned fundamental abilities. Then, we evaluate 3 representative LLMs with 3 different retrievers on 5 tasks over 9 datasets.

In any ranking system, the retrieval model outputs a single score for a document based on its belief on how relevant it is to a given search query. While retrieval models have continued to improve with the introduction of increasingly complex architectures, few works have investigated a retrieval model's belief in the score beyond the scope of a single value. We argue that capturing the model's uncertainty with respect to its own scoring of a document is a critical aspect of retrieval that allows for greater use of current models across new document distributions, collections, or even improving effectiveness for down-stream tasks. In this paper, we address this problem via an efficient Bayesian framework for retrieval models which captures the model's belief in the relevance score through a stochastic process while adding only negligible computational overhead. We evaluate this belief via a ranking based calibration metric showing that our approximate Bayesian framework significantly improves a retrieval model's ranking effectiveness through a risk aware reranking as well as its confidence calibration. Lastly, we demonstrate that this additional uncertainty information is actionable and reliable on down-stream tasks represented via cutoff prediction.

A key component of deep learning (DL) for natural language processing (NLP) is word embeddings. Word embeddings that effectively capture the meaning and context of the word that they represent can significantly improve the performance of downstream DL models for various NLP tasks. Many existing word embeddings techniques capture the context of words based on word co-occurrence in documents and text; however, they often cannot capture broader domain-specific relationships between concepts that may be crucial for the NLP task at hand. In this paper, we propose a method to integrate external knowledge from medical terminology ontologies into the context captured by word embeddings. Specifically, we use a medical knowledge graph, such as the unified medical language system (UMLS), to find connections between clinical terms in cancer pathology reports. This approach aims to minimize the distance between connected clinical concepts. We evaluate the proposed approach using a Multitask Convolutional Neural Network (MT-CNN) to extract six cancer characteristics -- site, subsite, laterality, behavior, histology, and grade -- from a dataset of ~900K cancer pathology reports. The results show that the MT-CNN model which uses our domain informed embeddings outperforms the same MT-CNN using standard word2vec embeddings across all tasks, with an improvement in the overall micro- and macro-F1 scores by 4.97\%and 22.5\%, respectively.

The medical domain is vast and diverse, with many existing embedding models focused on general healthcare applications. However, these models often struggle to capture a deep understanding of diseases due to their broad generalization across the entire medical field. To address this gap, I present DisEmbed, a disease-focused embedding model. DisEmbed is trained on a synthetic dataset specifically curated to include disease descriptions, symptoms, and disease-related Q\&A pairs, making it uniquely suited for disease-related tasks. For evaluation, I benchmarked DisEmbed against existing medical models using disease-specific datasets and the triplet evaluation method. My results demonstrate that DisEmbed outperforms other models, particularly in identifying disease-related contexts and distinguishing between similar diseases. This makes DisEmbed highly valuable for disease-specific use cases, including retrieval-augmented generation (RAG) tasks, where its performance is particularly robust.

Despite their recent popularity and well-known advantages, dense retrievers still lag behind sparse methods such as BM25 in their ability to reliably match salient phrases and rare entities in the query and to generalize to out-of-domain data. It has been argued that this is an inherent limitation of dense models. We rebut this claim by introducing the Salient Phrase Aware Retriever (SPAR), a dense retriever with the lexical matching capacity of a sparse model. We show that a dense Lexical Model {\Lambda} can be trained to imitate a sparse one, and SPAR is built by augmenting a standard dense retriever with {\Lambda}. Empirically, SPAR shows superior performance on a range of tasks including five question answering datasets, MS MARCO passage retrieval, as well as the EntityQuestions and BEIR benchmarks for out-of-domain evaluation, exceeding the performance of state-of-the-art dense and sparse retrievers. The code and models of SPAR are available at: https://github.com/facebookresearch/dpr-scale/tree/main/spar

Known for efficient computation and easy storage, hashing has been extensively explored in cross-modal retrieval. The majority of current hashing models are predicated on the premise of a direct one-to-one mapping between data points. However, in real practice, data correspondence across modalities may be partially provided. In this research, we introduce an innovative unsupervised hashing technique designed for semi-paired cross-modal retrieval tasks, named Reconstruction Relations Embedded Hashing (RREH). RREH assumes that multi-modal data share a common subspace. For paired data, RREH explores the latent consistent information of heterogeneous modalities by seeking a shared representation. For unpaired data, to effectively capture the latent discriminative features, the high-order relationships between unpaired data and anchors are embedded into the latent subspace, which are computed by efficient linear reconstruction. The anchors are sampled from paired data, which improves the efficiency of hash learning. The RREH trains the underlying features and the binary encodings in a unified framework with high-order reconstruction relations preserved. With the well devised objective function and discrete optimization algorithm, RREH is designed to be scalable, making it suitable for large-scale datasets and facilitating efficient cross-modal retrieval. In the evaluation process, the proposed is tested with partially paired data to establish its superiority over several existing methods.

Critical retained foreign objects (RFOs), including surgical instruments like sponges and needles, pose serious patient safety risks and carry significant financial and legal implications for healthcare institutions. Detecting critical RFOs using artificial intelligence remains challenging due to their rarity and the limited availability of chest X-ray datasets that specifically feature critical RFOs cases. Existing datasets only contain non-critical RFOs, like necklace or zipper, further limiting their utility for developing clinically impactful detection algorithms. To address these limitations, we introduce "Hopkins RFOs Bench", the first and largest dataset of its kind, containing 144 chest X-ray images of critical RFO cases collected over 18 years from the Johns Hopkins Health System. Using this dataset, we benchmark several state-of-the-art object detection models, highlighting the need for enhanced detection methodologies for critical RFO cases. Recognizing data scarcity challenges, we further explore image synthetic methods to bridge this gap. We evaluate two advanced synthetic image methods, DeepDRR-RFO, a physics-based method, and RoentGen-RFO, a diffusion-based method, for creating realistic radiographs featuring critical RFOs. Our comprehensive analysis identifies the strengths and limitations of each synthetic method, providing insights into effectively utilizing synthetic data to enhance model training. The Hopkins RFOs Bench and our findings significantly advance the development of reliable, generalizable AI-driven solutions for detecting critical RFOs in clinical chest X-rays.

Text-Video Retrieval aims to find the most relevant text (or video) candidate given a video (or text) query from large-scale online databases. Recent work leverages multi-modal large language models (MLLMs) to improve retrieval, especially for long or complex query-candidate pairs. However, we observe that the naive application of MLLMs, i.e., retrieval based on candidate likelihood, introduces candidate prior bias, favoring candidates with inherently higher priors over those more relevant to the query. To this end, we propose a novel retrieval framework, Bidirectional Likelihood Estimation with MLLM (BLiM), which leverages both query and candidate likelihoods by training the model to generate text from a given video as well as video features from a given text. Furthermore, we introduce Candidate Prior Normalization (CPN), a simple yet effective training-free score calibration module designed to mitigate candidate prior bias in candidate likelihood. On four Text-Video Retrieval benchmarks, our BLiM equipped with CPN outperforms previous state-of-the-art models by 6.4 R@1 on average, effectively alleviating candidate prior bias and emphasizing query-candidate relevance. Our in-depth analysis across various multi-modal tasks beyond retrieval highlights the broad applicability of CPN which enhances visual understanding by reducing reliance on textual priors. Code is available at https://github.com/mlvlab/BLiM.

Users may strive to formulate an adequate textual query for their information need. Search engines assist the users by presenting query suggestions. To preserve the original search intent, suggestions should be context-aware and account for the previous queries issued by the user. Achieving context awareness is challenging due to data sparsity. We present a probabilistic suggestion model that is able to account for sequences of previous queries of arbitrary lengths. Our novel hierarchical recurrent encoder-decoder architecture allows the model to be sensitive to the order of queries in the context while avoiding data sparsity. Additionally, our model can suggest for rare, or long-tail, queries. The produced suggestions are synthetic and are sampled one word at a time, using computationally cheap decoding techniques. This is in contrast to current synthetic suggestion models relying upon machine learning pipelines and hand-engineered feature sets. Results show that it outperforms existing context-aware approaches in a next query prediction setting. In addition to query suggestion, our model is general enough to be used in a variety of other applications.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

Automatic International Classification of Diseases (ICD) coding aims to assign multiple ICD codes to a medical note with average length of 3,000+ tokens. This task is challenging due to a high-dimensional space of multi-label assignment (tens of thousands of ICD codes) and the long-tail challenge: only a few codes (common diseases) are frequently assigned while most codes (rare diseases) are infrequently assigned. This study addresses the long-tail challenge by adapting a prompt-based fine-tuning technique with label semantics, which has been shown to be effective under few-shot setting. To further enhance the performance in medical domain, we propose a knowledge-enhanced longformer by injecting three domain-specific knowledge: hierarchy, synonym, and abbreviation with additional pretraining using contrastive learning. Experiments on MIMIC-III-full, a benchmark dataset of code assignment, show that our proposed method outperforms previous state-of-the-art method in 14.5% in marco F1 (from 10.3 to 11.8, P<0.001). To further test our model on few-shot setting, we created a new rare diseases coding dataset, MIMIC-III-rare50, on which our model improves marco F1 from 17.1 to 30.4 and micro F1 from 17.2 to 32.6 compared to previous method.

Background: Cancer remains one of the leading causes of morbidity and mortality worldwide. Comprehensive datasets that combine histopathological images with genetic and survival data across various tumour sites are essential for advancing computational pathology and personalised medicine. Results: We present SurGen, a dataset comprising 1,020 H&E-stained whole slide images (WSIs) from 843 colorectal cancer cases. The dataset includes detailed annotations for key genetic mutations (KRAS, NRAS, BRAF) and mismatch repair status, as well as survival data for 426 cases. To demonstrate SurGen's practical utility, we conducted a proof-of-concept machine learning experiment predicting mismatch repair status from the WSIs, achieving a test AUROC of 0.8316. These preliminary results underscore the dataset's potential to facilitate research in biomarker discovery, prognostic modelling, and advanced machine learning applications in colorectal cancer. Conclusions: SurGen offers a valuable resource for the scientific community, enabling studies that require high-quality WSIs linked with comprehensive clinical and genetic information on colorectal cancer. Our initial findings affirm the dataset's capacity to advance diagnostic precision and foster the development of personalised treatment strategies in colorectal oncology. Data available online at https://doi.org/10.6019/S-BIAD1285.

In this paper, we present DuReader_retrieval, a large-scale Chinese dataset for passage retrieval. DuReader_retrieval contains more than 90K queries and over 8M unique passages from a commercial search engine. To alleviate the shortcomings of other datasets and ensure the quality of our benchmark, we (1) reduce the false negatives in development and test sets by manually annotating results pooled from multiple retrievers, and (2) remove the training queries that are semantically similar to the development and testing queries. Additionally, we provide two out-of-domain testing sets for cross-domain evaluation, as well as a set of human translated queries for for cross-lingual retrieval evaluation. The experiments demonstrate that DuReader_retrieval is challenging and a number of problems remain unsolved, such as the salient phrase mismatch and the syntactic mismatch between queries and paragraphs. These experiments also show that dense retrievers do not generalize well across domains, and cross-lingual retrieval is essentially challenging. DuReader_retrieval is publicly available at https://github.com/baidu/DuReader/tree/master/DuReader-Retrieval.

We present Polish Information Retrieval Benchmark (PIRB), a comprehensive evaluation framework encompassing 41 text information retrieval tasks for Polish. The benchmark incorporates existing datasets as well as 10 new, previously unpublished datasets covering diverse topics such as medicine, law, business, physics, and linguistics. We conduct an extensive evaluation of over 20 dense and sparse retrieval models, including the baseline models trained by us as well as other available Polish and multilingual methods. Finally, we introduce a three-step process for training highly effective language-specific retrievers, consisting of knowledge distillation, supervised fine-tuning, and building sparse-dense hybrid retrievers using a lightweight rescoring model. In order to validate our approach, we train new text encoders for Polish and compare their results with previously evaluated methods. Our dense models outperform the best solutions available to date, and the use of hybrid methods further improves their performance.

Query expansion has been employed for a long time to improve the accuracy of query retrievers. Earlier works relied on pseudo-relevance feedback (PRF) techniques, which augment a query with terms extracted from documents retrieved in a first stage. However, the documents may be noisy hindering the effectiveness of the ranking. To avoid this, recent studies have instead used Large Language Models (LLMs) to generate additional content to expand a query. These techniques are prone to hallucination and also focus on the LLM usage cost. However, the cost may be dominated by the retrieval in several important practical scenarios, where the corpus is only available via APIs which charge a fee per retrieved document. We propose combining classic PRF techniques with LLMs and create a progressive query expansion algorithm ProQE that iteratively expands the query as it retrieves more documents. ProQE is compatible with both sparse and dense retrieval systems. Our experimental results on four retrieval datasets show that ProQE outperforms state-of-the-art baselines by 37% and is the most cost-effective.

This paper studies fast fusion of dense retrieval and sparse lexical retrieval, and proposes a cluster-based selective dense retrieval method called CluSD guided by sparse lexical retrieval. CluSD takes a lightweight cluster-based approach and exploits the overlap of sparse retrieval results and embedding clusters in a two-stage selection process with an LSTM model to quickly identify relevant clusters while incurring limited extra memory space overhead. CluSD triggers partial dense retrieval and performs cluster-based block disk I/O if needed. This paper evaluates CluSD and compares it with several baselines for searching in-memory and on-disk MS MARCO and BEIR datasets.

Despite the rapid development of natural language processing (NLP) implementation in electronic medical records (EMRs), Chinese EMRs processing remains challenging due to the limited corpus and specific grammatical characteristics, especially for radiology reports. In this study, we designed an NLP pipeline for the direct extraction of clinically relevant features from Chinese radiology reports, which is the first key step in computer-aided radiologic diagnosis. The pipeline was comprised of named entity recognition, synonyms normalization, and relationship extraction to finally derive the radiological features composed of one or more terms. In named entity recognition, we incorporated lexicon into deep learning model bidirectional long short-term memory-conditional random field (BiLSTM-CRF), and the model finally achieved an F1 score of 93.00%. With the extracted radiological features, least absolute shrinkage and selection operator and machine learning methods (support vector machine, random forest, decision tree, and logistic regression) were used to build the classifiers for liver cancer prediction. For liver cancer diagnosis, random forest had the highest predictive performance in liver cancer diagnosis (F1 score 86.97%, precision 87.71%, and recall 86.25%). This work was a comprehensive NLP study focusing on Chinese radiology reports and the application of NLP in cancer risk prediction. The proposed NLP pipeline for the radiological feature extraction could be easily implemented in other kinds of Chinese clinical texts and other disease predictive tasks.

Survey data can contain a high number of features while having a comparatively low quantity of examples. Machine learning models that attempt to predict outcomes from survey data under these conditions can overfit and result in poor generalizability. One remedy to this issue is feature selection, which attempts to select an optimal subset of features to learn upon. A relatively unexplored source of information in the feature selection process is the usage of textual names of features, which may be semantically indicative of which features are relevant to a target outcome. The relationships between feature names and target names can be evaluated using language models (LMs) to produce semantic textual similarity (STS) scores, which can then be used to select features. We examine the performance using STS to select features directly and in the minimal-redundancy-maximal-relevance (mRMR) algorithm. The performance of STS as a feature selection metric is evaluated against preliminary survey data collected as a part of a clinical study on persistent post-surgical pain (PPSP). The results suggest that features selected with STS can result in higher performance models compared to traditional feature selection algorithms.

Pathological diagnosis remains the definitive standard for identifying tumors. The rise of multimodal large models has simplified the process of integrating image analysis with textual descriptions. Despite this advancement, the substantial costs associated with training and deploying these complex multimodal models, together with a scarcity of high-quality training datasets, create a significant divide between cutting-edge technology and its application in the clinical setting. We had meticulously compiled a dataset of approximately 45,000 cases, covering over 6 different tasks, including the classification of organ tissues, generating pathology report descriptions, and addressing pathology-related questions and answers. We have fine-tuned multimodal large models, specifically LLaVA, Qwen-VL, InternLM, with this dataset to enhance instruction-based performance. We conducted a qualitative assessment of the capabilities of the base model and the fine-tuned model in performing image captioning and classification tasks on the specific dataset. The evaluation results demonstrate that the fine-tuned model exhibits proficiency in addressing typical pathological questions. We hope that by making both our models and datasets publicly available, they can be valuable to the medical and research communities.

Domain specific question answering is an evolving field that requires specialized solutions to address unique challenges. In this paper, we show that a hybrid approach combining a fine-tuned dense retriever with keyword based sparse search methods significantly enhances performance. Our system leverages a linear combination of relevance signals, including cosine similarity from dense retrieval, BM25 scores, and URL host matching, each with tunable boost parameters. Experimental results indicate that this hybrid method outperforms our single-retriever system, achieving improved accuracy while maintaining robust contextual grounding. These findings suggest that integrating multiple retrieval methodologies with weighted scoring effectively addresses the complexities of domain specific question answering in enterprise settings.

When re-finding items, users who forget or are uncertain about identifying details often rely on creative strategies for expressing their information needs -- complex queries that describe content elements (e.g., book characters or events), information beyond the document text (e.g., descriptions of book covers), or personal context (e.g., when they read a book). This retrieval setting, called tip of the tongue (TOT), is especially challenging for models heavily reliant on lexical and semantic overlap between query and document text. In this work, we introduce a simple yet effective framework for handling such complex queries by decomposing the query into individual clues, routing those as sub-queries to specialized retrievers, and ensembling the results. This approach allows us to take advantage of off-the-shelf retrievers (e.g., CLIP for retrieving images of book covers) or incorporate retriever-specific logic (e.g., date constraints). We show that our framework incorportating query decompositions into retrievers can improve gold book recall up to 7% relative again for Recall@5 on a new collection of 14,441 real-world query-book pairs from an online community for resolving TOT inquiries.