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01.
arXiv (CS.CL) 2026-06-15

When Plausible Is Not Realistic: Evaluating Human Mobility in LLM-Based Urban Simulation

LLM-based generative agents are increasingly used in urban simulators, yet it remains unclear whether they reproduce empirically realistic human mobility patterns or merely generate plausible mobility narratives. We introduce a validation framework for evaluating the mobility of generative agents of LLM-based urban simulators against real-world mobility data. For this, we use mobility laws, temporal rhythms, network motifs, semantic activity transitions, and behavioral mobility profiles. Using datasets from the Greater Paris region and Shanghai, we evaluate AgentSociety and CitySim across multiple dimensions of mobility realism. Our analysis reveals a substantial gap between narrative plausibility and empirical mobility realism. Although the simulators capture some high-level semantic activity distributions, they struggle to reproduce core spatial and temporal constraints, including realistic trip-length distributions, origin-destination flows, dwell times, and transition dynamics. We further observe that realistic mobility diversity is unstable across default prompting configurations and may require explicit profile-aware initialization. To support reproducible evaluation, we also contribute scalable and open LLM-driven infrastructure for regional-scale map generation, observability-enhanced simulation, mobility-metric computation, and traffic simulation. Our findings highlight the need for rigorous empirical validation of LLM-based urban simulators and provide practical tools for building more realistic and reproducible urban simulation systems.

02.
arXiv (math.PR) 2026-06-18

Rigidity of infinite exchangeable sequences with Gaussian marginals

arXiv:2606.18654v1 Announce Type: new Abstract: We study infinite exchangeable sequences with Gaussian one-dimensional marginals. We formulate the conjecture that joint Gaussianity of a single pair of coordinates forces the entire sequence to be a Gaussian process. Although this conjecture remains open, we prove that joint Gaussianity of the first four coordinates is sufficient. We also establish the corresponding two-point criterion under the additional assumption that the directing measure is almost surely infinitely divisible.

03.
arXiv (CS.CV) 2026-06-12

VideoMDM: Towards 3D Human Motion Generation From 2D Supervision

We introduce VideoMDM, a diffusion-based framework that trains 3D human motion priors directly from accurate 2D poses extracted from monocular videos, without any 3D ground truth. A pretrained 2D-to-3D lifter provides approximate 3D pose sequences that serve as a noisy teacher: these are diffused, denoised by the model in 3D, and supervised in 2D by reprojecting the prediction and comparing against accurate keypoints. We show that, under mild assumptions, a depth-weighted 2D reprojection loss is equivalent in expectation to direct 3D supervision, and we adapt standard 3D motion regularizers - velocity consistency and over-parameterized representation alignment - to this 2D setting. Unlike methods that lift 2D to 3D only at inference, VideoMDM learns a coherent 3D motion manifold during training. On HumanML3D it nearly closes the gap to fully 3D-supervised MDM (FID 0.88 vs 0.54); On real video datasets Fit3D and NBA the method learns to generate motions consistently preferred by humans, with strong quantitative results.

04.
arXiv (math.PR) 2026-06-24

Quantitative Homogenization of PDEs with Neumann boundary conditions: a probabilistic approach

arXiv:2606.24304v1 Announce Type: new Abstract: In this paper, we study quantitative homogenization for viscosity solutions of multi-scale semilinear second order partial differential equations (PDEs) on convex domains with Neumann boundary conditions. To this aim we use the probabilistic approach by studying the quantitative homogenization of backward stochastic differential equations (SDEs) associated with slow-fast systems of reflected SDEs.

05.
arXiv (quant-ph) 2026-06-19

Approximating optimal decoding of quantum LDPC codes with narrow frontiers

arXiv:2606.20513v1 Announce Type: new Abstract: We introduce the Frontier decoder, a pruned dynamic-programming decoder for sparse quantum decoding problems. Frontier processes error variables in a chosen order, merges prefixes with the same residual syndrome and logical label, and approximates logical-coset posterior masses by retaining only a narrow scored frontier. Without pruning, the recursion is exact ordered inference with exponential complexity. In the code-capacity setting, the decoder reaches thresholds close to optimal for the surface code and the color code. In the circuit-level noise model, it achieves state-of-the-art performance with a very small average retained list size: less than 100 for the gross code $[[144,12,12]]$ at a physical error rate of $0.001$. When the list size is constant, the decoder has linear complexity, suggesting the possibility of low-latency implementations.

06.
medRxiv (Medicine) 2026-06-11

Long-term exposure to PM2.5 components and lipid profiles in WTC Health Program general responders

Fine particulate matter (PM2.5) was found to be associated with elevated blood lipids, but fewer studies have examined the associations with specific constituents of PM2.5. We studied the associations between exposure to annual PM2.5 and its 14 constituents, and repeated blood lipid measurements among general responders enrolled in the World Trade Center Health Program between 2003 and 2019 (n = 44,876). We used generalized additive mixed effect models to investigate the single-pollutant associations with repeated measures of blood total cholesterol (TC), high and low-density lipoprotein (HDL-C and LDL-C) levels. We then used linear generalized weighted quantile sum regression with a random intercept for participant ID to account for the clustering of repeated measures and evaluate the combined associations with the component mixture. A decile increase in the mixture of 14 PM2.5 chemical components was associated with 0.375 mg/dL increase in TC levels (95% confidence Interval (CI): 0.174-0.577) and 0.302 mg/dL increase in LDL-C (95% CI: 0.063, 0.540). Lead, organic carbon, and iron were major drivers of both associations. Component-specific models also show higher TC and LDL levels associated with interquartile range increases in organic carbon (0.472, 95% CI [0.027, 0.918] and 0.648 95% CI [0.136, 1.160]) and iron exposure (1.081, 95% CI [0.630, 1.532] and 0.748, 95% CI [0.318, 1.178]). In conclusion, we found PM2.5 exposure to be associated with elevated lipid levels. The associations differed by PM2.5 composition, highlighting organic carbon, lead, and iron and major drivers. These findings are highly significant for a population exposed to extreme air pollution event and susceptible to lipid alterations that might trigger cardiovascular events.

07.
medRxiv (Medicine) 2026-06-15

Wellbeing After Stroke-2 (WAterS-2): a feasibility study with process evaluation exploring inclusive, accessible, online psychological support after stroke

Objectives: Explore feasibility and acceptability of upskilling a workforce to deliver a co-developed intervention, based on Acceptance and Commitment Therapy (ACT), to support psychological adjustment post-stroke targeting underserved groups. Design: Multi-site, single-arm feasibility study with embedded mixed-methods process evaluation (ISRCTN17628580). Setting: Four NHS community stroke services across England. Participants: 1. Stroke survivors [≥]18 years of age, [≥]4 months post-stroke, reporting psychological difficulties adjusting to stroke, able to consent and access remote group sessions in English; 2. Group facilitators from NHS stroke services, not ACT specialists. Intervention: WAterS-2: an eight-session, remotely-delivered ACT-informed group intervention. Outcome measures: Recruitment, fidelity, safety, acceptability and perceived value were assessed using fidelity checklists, post-intervention surveys and semi-structured interviews with stroke survivors and facilitators. Clinical outcomes including mood (HADS), wellbeing (ONS4), psychological flexibility (AAQ-ABI), measured post-group and three-months later. Results: Nineteen stroke survivors recruited (mean 9.6 months post-stroke; n=5 (26%) minoritised ethnicities; n=10 (52%) with aphasia). Thirteen facilitators - including two peer support workers - delivered the intervention with fidelity following structured training across four services. Drop-out was low (2/19; 11%); with 15 (79%) attending [≥]5/8 sessions. Remote data collection was feasible (79% follow-up completion), with no adverse events recorded. Acceptability was high: survivors valued peer connection, grounding and mindfulness practices. ACT metaphors were helpful for some but challenging for others, including some with aphasia. Online delivery was suitable but limited informal connection. Facilitators reported increased capability, incorporating ACT skills into routine care. NHS workforce pressures and geographically-constrained referral pathways limited recruitment reach. Conclusions: WAterS-2 is feasible, safe, acceptable and inclusive. A mixed workforce, including NHS peer support workers, can be upskilled to deliver with fidelity. Inclusion of underserved groups is achievable but requires active strategies beyond standard NHS referral routes. Findings inform a provisional logic model and a future pragmatic trial.

08.
Nature (Science) 2026-06-09

People are turning to AI chatbots to plug gaps in health information

A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies. A systematic assessment of health-related queries to a chatbot powered by artificial intelligence highlights shortfalls in health-care provision and the responsibilities of AI companies.

09.
arXiv (CS.CL) 2026-06-19

Gender Bias in LLM Hiring Decisions: Evidence from a Japanese Context and Evaluation of Mitigation Strategies

Large language models (LLMs) are increasingly deployed in hiring workflows, yet most research on gender bias in LLM hiring decisions has focused on English-language, Western-format resumes. This study examines whether pro-female gender bias extends to a Japanese corporate context and evaluates two practical mitigation strategies. Using a counterfactual resume design with 60 Japanese rirekisho-format resumes, 12 name pairs selected on linguistically grounded gender-signal criteria, and five state-of-the-art LLMs (Claude Sonnet 4.6, GPT-4o, DeepSeek-V3, Gemini 2.5 Flash, Llama 3.3 70B), we conducted 43,200 API calls across baseline, prompt instruction, and privacy filter conditions. A crossed random-effects linear mixed model confirms a significant pro-female bias across all five models, replicating Western findings in a non-Western context. A prompt-level gender-neutrality instruction produces no meaningful reduction in bias. A name-reliance analysis formally identifies the candidate name as the primary gender channel: removing the name from the prompt reduces the female effect by nearly its full magnitude. An unexpected incompatibility between the privacy filter and GPT-4o's content safety filter, resulting in a 42% refusal rate, highlights a practical deployment challenge for name anonymization in LLM-assisted recruitment pipelines.

10.
arXiv (CS.LG) 2026-06-12

Authority, Truth, and Citation Bias: A Large-Scale Multi-Domain Benchmark for Studying Epistemic Susceptibility in Large Language Models

arXiv:2606.13104v1 Announce Type: new Abstract: Large language models are increasingly deployed in citation-augmented settings, yet the effect of citation presence on model behavior independent of factual content remains poorly understood. We introduce AuthorityBench, a 220,564-prompt multi-domain benchmark that isolates how citation-based authority signals influence epistemic behavior in LLMs. The benchmark uses a fully balanced 2x2 factorial design crossing claim veracity with citation veracity, the first to do so, across four domains (general knowledge, science, law, and medicine), with controlled variation over 40 prompt templates, four venue prestige tiers, and a country-coded author name dataset. Evaluating seven models on 12 structured research questions, we find that citation presence, whether real or fabricated, consistently increases hallucination rates relative to a no-citation baseline. The effect is strongest when fabricated citations accompany true claims, raising hallucination rates by 3 to 22 percentage points and reaching 35 to 77% in the general knowledge domain, while legal claims are comparatively robust and venue prestige and author demographics show negligible impact. All datasets and evaluation code are available at: https://github.com/floating-reeds/AuthorityBench

11.
arXiv (CS.CV) 2026-06-24

BioMedVR: Confusion-Aware Mixture-of-Prompt Experts for Biomedical Visual Reprogramming

Recent advances in vision-language models (VLMs) such as CLIP have demonstrated strong generalization across natural-image domains. However, adapting these models to biomedical imaging is non-trivial: full-model fine-tuning is computationally expensive, while medical data are often scarce and exhibit subtle, fine-grained inter-class differences, making parameter-efficient adaptation particularly critical. Visual Reprogramming (VR) offers a parameter-efficient alternative by injecting learnable perturbations into the input space, but existing VR approaches for VLMs mainly focus on positive class prompts and overlook confusing negatives, leading to miscalibrated predictions in fine-grained medical scenarios. We present BioMedVR, the first VR-based framework for biomedical imaging, enabling few-shot adaptation of pretrained VLMs through compact learnable VR modules. To mitigate class confusion, we introduce a Confusion Minimization Mechanism that leverages LLM-generated confusion-aware attributes together with a Confusion-Suppression Loss to explicitly reduce false-positive alignment. Moreover, the designed Mixture-of-Prompt Experts combines a positive expert for main-class discrimination and a negative expert for confusion suppression, balanced via adaptive gating. Extensive experiments on 18 datasets, including 11 biomedical datasets and 7 natural image benchmarks, demonstrate that BioMedVR achieves superior accuracy and generalization, effectively bridging VR and VLMs in biomedical domains.

12.
arXiv (CS.AI) 2026-06-19

HilDA: Hierarchical Distillation with Diffusion for Advancing Self-Supervised LiDAR Pre-trainin

arXiv:2606.20189v1 Announce Type: cross Abstract: Leveraging Vision Foundation Models (VFMs) for camera-to-LiDAR knowledge distillation offers a promising solution to the scarcity of annotated data needed to represent the immense geometric and kinematic diversity of real-world autonomous driving (AD). However, current approaches typically treat VFMs as black-box teachers, relying exclusively on frame-wise feature similarity. Consequently, they do not fully exploit the teacher's layer-wise semantic structure and global context, as well as the rich spatiotemporal information inherent in LiDAR sequences. We propose HilDA, a self-supervised pretraining framework for LiDAR backbones that better captures the semantic what and geometric where needed for driving tasks. HilDA combines hierarchical distillation comprising multi-layer distillation for progressive semantic alignment and global context distillation for scene-level semantics, with a temporal occupancy diffusion objective promoting spatiotemporal consistency. Models pre-trained with HilDA achieve state-of-the-art results on cross-modal distillation benchmarks and outperform models trained via prior distillation approaches on 3D object detection, scene flow, and semantic occupancy prediction. Code available at: https://maxiuw.github.io/hilda.

13.
arXiv (CS.LG) 2026-06-24

Stochastic Expectation Maximization for Robust State-Space Radio Interferometric Imaging

arXiv:2606.23944v1 Announce Type: cross Abstract: State–space models provide a flexible framework for analyzing dynamical systems, yet they often rely on Gaussian assumptions that fail to capture heavy-tailed or outlier-prone measurement noise. We propose a robust estimation scheme for linear state–space models subject to compound-Gaussian noise, as encountered for instance in radio interferometry affected by radio-frequency interference (RFI). The method relies on a Stochastic Approximation Expectation–Maximization (SAEM) algorithm in which the standard E-step is replaced by Monte Carlo sampling of the latent states and noise texture through closed-form Gibbs updates, enabling tractable inference despite the heavy-tailed likelihood. Numerical experiments show that the proposed method significantly improves reconstruction fidelity and robustness to RFI, outperforming a Gaussian EM algorithm and even an oracle RTS smoother. These results highlight the benefits of heavy-tailed state–space modeling and SAEM-based inference in interference-dominated imaging scenarios.

14.
arXiv (CS.CL) 2026-06-16

Beyond Text-to-SQL: An Agentic LLM System for Governed Enterprise Analytics APIs

Enterprise analytics aims to make organizational data accessible for decision-making, yet non-technical users still face barriers when using traditional business intelligence tools or Text-to-SQL systems. While recent Text-to-SQL approaches based on Large Language Models (LLMs) promise natural language access to structured data, they fall short in enterprise settings where analytics pipelines rely on governed APIs rather than raw databases. In practice, these APIs encapsulate complex business logic to ensure consistency, auditability, and security. However, delegating mathematical or aggregation logic to an LLM introduces reliability and compliance risks. To this end, we present Analytic Agent, an LLM-based agentic system that translates natural language intents into secure interactions with enterprise analytics APIs. Evaluated on 90 real enterprise use cases constructed by domain experts, it reliably interprets user goals, validates permissions, executes governed queries, and generates compliant visualizations through multi-step reasoning and policy-aware orchestration.

15.
arXiv (CS.CV) 2026-06-16

PATCH: Action-Chunk-Conditioned Latent Patch Innovation Monitoring for Robot Manipulation

Learning-based manipulation policies have made substantial progress in real-world robot manipulation, particularly for short-horizon action generation. However, deployment in open workspaces remains fragile under unexpected local scene dynamics, such as moving objects, transient occlusions, or disturbances near the intended motion. Existing runtime monitors often rely on global observation anomalies, policy uncertainty, or frame-level visual changes, and struggle to distinguish task-relevant execution risk from benign visual variation. We introduce PATCH, an action-chunk-conditioned latent patch innovation monitor for deployment-time intervention. Given the active action chunk, PATCH defines a projected execution corridor, predicts latent patch evolution inside it, and accumulates persistent residuals unexplained by the robot's own motion. These residuals form a localized intervention signal that allows PATCH-Router to pause execution, select an available recovery source, and resume the original policy once localized innovation subsides. Experiments on real robot rollout data show that PATCH produces more stable and context-relevant triggers than competing runtime monitors. Real-robot deployment further demonstrates monitor-driven intervention and policy resumption for disturbance-aware manipulation. Project Page: https://yananzhou5555.github.io/PATCH/.

16.
arXiv (CS.LG) 2026-06-11

Projected random forests and conformal prediction of circular data

arXiv:2410.24145v3 Announce Type: replace-cross Abstract: We apply conformal prediction techniques to regression problems with circular responses, producing prediction sets with adaptive arc length and finite-sample coverage guarantees for any circular predictive model under the assumption of data exchangeability. Leveraging the high performance of existing predictive models designed for linear responses, we analyze a general projection procedure that converts any linear-response regression model into one suitable for circular responses. When random forests are used as base models in this projection procedure, we leverage the random forest out-of-bag mechanism to eliminate the need for a separate calibration sample in the construction of prediction sets. On synthetic and real datasets, the resulting projected random forest model produces more efficient out-of-bag conformal prediction sets, with shorter median arc length, than the split conformal prediction sets generated by two existing alternative models.

17.
arXiv (quant-ph) 2026-06-17

Quantum Routers: A Switching-Fabric Framework for Quantum-Native Forwarding

arXiv:2606.17773v1 Announce Type: new Abstract: Forwarding in quantum networks cannot be realized by directly transposing classical switching fabrics, since the no-cloning theorem and the quantum measurement postulate constrain the direct relay of quantum information while ruling out copy-based buffering and inspection. In this paper, we propose a switching-fabric framework for quantum routers based on multipartite entanglement. Specifically, we formalize the notion of an entanglement-based switching fabric, in which a graph state acts as the forwarding resource and entanglement forwarding is realized through local Pauli measurements. We translate the classical notions of blocking and non-blocking operation into structural conditions for entanglement-based fabrics, by deriving the edge-controlled (EC) design principle for non-blocking operation. We instantiate this principle through a monolithic EC crossbar and a modular Clos-type EC fabric, for which we characterize resource scaling and identify the regime where the modular design becomes more resource-efficient than the monolithic one. Finally, a forwarding-latency analysis establishes a fundamental distinction between matching-oblivious and matching-driven forwarding: the proposed EC fabrics realize all requested input-output entanglement links with constant forwarding depth under sufficient measurement parallelism, whereas matching-driven EPR-based fabrics exhibit latency that scales with the number of requested connections. The proposed framework provides a hardware-agnostic foundation for quantum-router switching fabrics.

18.
arXiv (quant-ph) 2026-06-11

Holographic Complexity, Extremality, and Cosmic Censorship

arXiv:2604.20170v2 Announce Type: replace-cross Abstract: We propose a holographic complexity origin for the third law of black-hole mechanics and weak cosmic censorship. In both complexity equals action and complexity equals volume prescriptions, the relative complexity between subextremal and extremal AdS black holes diverges logarithmically. For overcharged RN-AdS, explicit calculations in both prescriptions show that the near-singularity action terms are power-law divergent or finite, while the maximal-volume contribution is finite. Thus, the extremal-to-naked relative complexity also diverges, obstructing finite-time transitions.

19.
arXiv (CS.LG) 2026-06-11

LakeFM: Toward a Foundation Model for Aquatic Ecosystems Using Irregular Multivariate Multi-depth Time Series Data

arXiv:2606.11268v1 Announce Type: new Abstract: Understanding and forecasting lake dynamics is critical for monitoring water quality and ecosystem health across lakes and reservoirs. While machine learning methods have been recently applied to ecological time-series data, existing works assume regular sampling in time and depth, and struggle to generalize across lakes with heterogeneous variables, depths, and observation patterns. To address these limitations, we introduce \textsc{LakeFM}, a foundation model for aquatic systems, pre-trained on large-scale ecological datasets comprising both simulated and observed lakes. Through extensive empirical evaluation, we show that \textsc{LakeFM} learns meaningful representations spanning broader lake-level characteristics, and achieves competitive or often superior-forecasting performance compared to existing time-series foundation and non-foundation models, while producing physically plausible predictions consistent with real-world lake dynamics.

20.
arXiv (CS.AI) 2026-06-19

Structuring and Tokenizing Distributed User Interest Context for Generative Recommendation

arXiv:2606.20554v1 Announce Type: cross Abstract: Generative recommendation is an emerging paradigm that has shown promise in industrial recommendation systems, aiming to predict users' next interactions from their historical behaviors. At the core of generative recommendation lies item tokenization, which bridges item semantics and recommendation models. However, existing methods often struggle to effectively organize and inject complex user-behavioral and item-semantic contexts into recommendation models simultaneously. On the one hand, existing graph-based integration methods, such as graph serialization and graph neural networks, either suffer from scalability issues or exploit only local graph information. On the other hand, existing semantic tokenization methods typically rely on heuristics and lack explicit supervision signals, which may lead to inaccurate or suboptimal semantic representations. To address these limitations in user interest context modeling, we propose G2Rec, a scalable framework that unifies holistic graph-based user co-engagement modeling with semantic tokenization for industrial-scale generative recommendation. Overall, G2Rec enables recommendation models to capture holistic and semantically grounded user interest prototypes without requiring ground-truth user interests, thereby providing more comprehensive and accurate modeling of user behavior contexts in industrial sequential recommendation. Online deployment across product surfaces and extensive experiments on public datasets demonstrate the superiority of G2Rec over existing methods.

21.
bioRxiv (Bioinfo) 2026-06-10

When batch correction corrupts gene expression: uncovering distortions in correlation structures

Batch correction is essential for integrating datasets and enabling population-level insights into health and disease. Embedding-based approaches are among the most widely used solutions, but here we highlight a critical, overlooked limitation: these methods can distort feature-to-feature (e.g., gene gene) relationships, potentially undermining downstream analyses. We investigate this issue and introduce a novel metric to quantify it.

22.
arXiv (CS.LG) 2026-06-19

Statistical Properties of Training & Generalization

arXiv:2606.20299v1 Announce Type: cross Abstract: Deep learning has managed to evade numerous intuitions from classical statistics to achieve unprecedented performance on a number of real-world tasks. In this article, we investigate the key features and surprises of deep learning from a physics-informed perspective, taking care to point out and justify where possible the many choices inherent in constructing a deep learning model. In particular, we review the phenomenon of neural scaling laws and discuss their interplay with the constraints and inductive biases which may be present when applying machine learning to problems in physics.

23.
arXiv (CS.CL) 2026-06-24

Exploring Academic Influence of Algorithms by Co-occurrence Network Based on Full-text of Academic Papers

Algorithms have become central to scientific research in the era of artificial intelligence (AI). Although algorithm mentions in papers are often used to indicate popularity and influence, existing studies usually evaluate individual algorithms in isolation and pay limited attention to the collective influence formed through their interconnections. This study constructs large-scale algorithm co-occurrence networks in natural language processing (NLP) based on the full text of academic papers and investigates algorithm influence from a network perspective. Using deep learning models, we extract algorithm entities and build overall, cumulative, and annual co-occurrence networks. We analyze their structural characteristics and apply multiple centrality measures to assess the group influence of algorithms across the whole field and over time. The results show that algorithm networks display typical features of complex networks, with increasingly dense connections developing over approximately two decades. Classic, high-performing algorithms and those located at the intersections of different research periods tend to have high popularity, control, centrality, and balanced influence. When the influence of an algorithm declines, it usually loses its core network position first, followed by weaker associations with other algorithms. This study is the first large-scale analysis of algorithm co-occurrence networks. Covering more than four decades of academic publications, it provides a temporal and structural view of algorithm influence and offers a foundation for future research on networks linking algorithms, scholars, and tasks.

24.
arXiv (CS.AI) 2026-06-18

Do Neural Networks Lose Plasticity in a Gradually Changing World?

arXiv:2602.09234v2 Announce Type: replace-cross Abstract: Continual learning has become a trending topic in machine learning. Recent studies have discovered an interesting phenomenon called loss of plasticity, referring to neural networks gradually losing the ability to learn new tasks. However, existing plasticity research largely relies on benchmarks with abrupt task transitions, without examining whether the abruptness itself contributes to the observed plasticity loss. In this paper, we investigate the role of transition abruptness by simulating gradually changing environments through input/output interpolation and task sampling. We perform theoretical and empirical analysis, showing that the severity of plasticity loss is closely tied to the abruptness of task transitions, and can be substantially reduced when the environment changes gradually.

25.
arXiv (CS.CL) 2026-06-15

Can Post-Training Turn LLMs into Good Medical Coders? An Empirical Study of Generative ICD Coding

Automated International Classification of Diseases (ICD) coding is a core medical-coding task for billing, epidemiology, and clinical decision support. Generative large language models (LLMs) are often reported as weak medical coders, but this finding mainly comes from inference-time settings such as prompting, retrieval, reranking, or tool use, leaving the role of task-specific post-training underexplored. We present a controlled empirical study of post-training for generative ICD coding, comparing discriminative baselines with LLM coders across prompting, supervised fine-tuning, and reinforcement learning under a common protocol and metric set. To our knowledge, this is the first study to evaluate RL-based post-training for generative LLM coders in ICD coding. We further introduce PHI, a diagnostic curriculum that extends GRPO to refine missed-code cases. Our results show that prompting-only evaluation substantially underestimates the potential of LLMs for ICD coding. SFT provides the main capability jump, GRPO further improves code-set prediction beyond SFT, and PHI provides targeted gains on macro-level performance. These findings suggest that the main bottleneck is not the generative formulation alone, but how the model is adapted and optimized for full-taxonomy recall. We release our code, data splits, and checkpoints at https://github.com/AlexandreWANG915/LLM4ICD.