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01.
arXiv (CS.CL) 2026-06-17

LegalHalluLens: Typed Hallucination Auditing and Calibrated Multi-Agent Debate for Trustworthy Legal AI

AI systems deployed in legal workflows hallucinate at rates that aggregate metrics report at ~52%, but this average conceals where errors concentrate and in which direction they run, leaving compliance officers without an actionable signal for trustworthy deployment. We present LegalHalluLens, an auditing framework with three components: typed hallucination profiles across four legally-motivated claim categories (numeric, temporal, obligation/entitlement, factual) over CUAD (Hendrycks et al., 2021); a Risk Direction Index (RDI) that reduces omission-versus-invention bias to a single deployment-comparable scalar; and a typed debate pipeline calibrated to both magnitudes and directions. Across 510 contracts and 249,252 clause-level instances we measure a within-model gap of approximately 38-40 pp between obligation/numeric and temporal claims that aggregate reporting hides, and show that two systems with matched 52% rates can carry opposite RDIs. The debate pipeline reduces fabricated detections by 45% with per-category gains tracking the diagnosis, matching commercial APIs with a substantially smaller backbone (4B active parameters). Typed profiles and RDI surface failure modes that aggregate metrics hide; we further show these diagnostics serve as calibration inputs for multi-agent debate pipelines, where Skeptic challenges and asymmetric gates targeted at measured failure modes outperform generically-tuned debate. The framework supports direction-aware procurement, accountability, and agent design for legal AI deployed in the wild.

02.
bioRxiv (Bioinfo) 2026-06-18

Trajectory inference of epithelial-centered neighborhood profiles reconstructs a pseudo-temporal continuum in idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is characterized by complex lung architecture and spatially heterogeneous remodeling, which have hindered integrated analysis of cell-intrinsic activity and intercellular communication during disease progression. Here we profiled six IPF lung specimens comprising more than 630,000 cells using the Xenium 5k panel and developed an epithelial-centered neighborhood profiling framework based on the local cellular composition around each epithelial cell. This approach captured fibrosis-associated variation in epithelial niches without requiring predefined histological regions. Pseudo-temporal continuum inference of these profiles reconstructed a continuous axis that reflected the spatial progression of fibrotic remodeling from relatively preserved alveolar regions to fibrotic and airway-like remodeled regions. Within this spatial dataset, we mapped coordinated changes in epithelial states, local microenvironments, epithelial intracellular pathway activities, and directional interactions with neighboring cell types along the same axis. Our findings provide a spatial framework that generates testable hypotheses for progressive epithelial niche remodeling in IPF.

03.
arXiv (CS.AI) 2026-06-16

An Attention Mechanism for Robust Multimodal Integration in a Global Workspace Architecture

arXiv:2602.08597v3 Announce Type: replace Abstract: Robust multimodal systems must remain effective when some modalities are noisy, degraded, or unreliable. Existing multimodal fusion methods often learn modality selection jointly with representation learning, making it difficult to determine whether robustness comes from the selector itself or from full end-to-end co-adaptation. Motivated by Global Workspace Theory (GWT), we study this question using a lightweight top-down modality selector operating on top of a frozen multimodal global workspace. We evaluate our method on two multimodal datasets of increasing complexity: Simple Shapes and MM-IMDb 1.0, under structured modality corruptions. The selector improves robustness while using far fewer trainable parameters than end-to-end attention baselines, and the learned selection strategy transfers better across downstream tasks, corruption regimes, and even to a previously unseen modality. Beyond explicit corruption settings, on the MM-IMDb 1.0 benchmark, we show that the same mechanism improves the global workspace over its no-attention counterpart and yields decent benchmark performance.

04.
arXiv (CS.LG) 2026-06-16

Maximum Entropy Inverse Reinforcement Learning for Mean-Field Games with Average Reward

arXiv:2606.16759v1 Announce Type: new Abstract: We study inverse reinforcement learning for discrete-time, infinite-horizon mean-field games (MFGs) under an average-reward criterion. Expert demonstrations are assumed to arise from a stationary mean-field equilibrium under an unknown reward, and the goal is to recover a policy explaining the observed behaviour via the maximum causal entropy principle. We formulate the inverse problem by enforcing consistency with the expert mean-field term and long-run feature expectations, treating two reward classes within a unified occupation-measure framework. For finite-dimensional linear rewards, we give a convex dual reformulation with an explicit log-partition objective, and prove smoothness and curvature properties justifying constant-step-size gradient descent. For infinite-dimensional RKHS rewards, we develop a Lagrangian relaxation whose inner-maximising policy is characterised by a soft Bellman equation. The main obstacle is the absence of a discount-factor contraction. We resolve this by introducing a minorisation-based sub-stochastic kernel that yields a strict contraction of the soft Bellman operator. We establish Fréchet differentiability and Lipschitz smoothness of the log-likelihood score, leading to a gradient ascent algorithm with convergence guarantees. Two numerical examples, a malware-spread MFG and an RKHS-based consumer-choice model, show that the recovered policies closely match expert behaviour.

05.
arXiv (CS.LG) 2026-06-11

Hierarchical Probabilistic Conformal Prediction for Distributed Energy Resources Adoption

arXiv:2411.12193v4 Announce Type: replace-cross Abstract: The rapid growth of distributed energy resources (DERs) presents both opportunities and operational challenges for electric grid management. Accurately predicting DER adoption is critical for proactive infrastructure planning, but the inherent uncertainty and spatial disparity of DER growth complicate traditional forecasting approaches. Moreover, the hierarchical structure of distribution grids demands that predictions satisfy statistical guarantees at both the circuit and substation levels, a non-trivial requirement for reliable decision-making. In this paper, we propose a novel uncertainty quantification framework for DER adoption predictions that ensures validity across hierarchical grid structures. Leveraging a multivariate Hawkes process to model DER adoption dynamics and a tailored split conformal prediction algorithm, we introduce a new nonconformity score that preserves statistical guarantees under aggregation while maintaining prediction efficiency. We establish theoretical validity under mild conditions and demonstrate through empirical evaluation on customer-level solar panel installation data from Indianapolis, Indiana that our method consistently outperforms existing baselines in both predictive accuracy and uncertainty calibration.

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

Calibrating Decision Robustness via Inverse Conformal Risk Control

arXiv:2510.07750v3 Announce Type: replace-cross Abstract: Robust optimization safeguards decisions against uncertainty by optimizing against worst-case scenarios, yet their effectiveness hinges on a prespecified robustness level that is often chosen ad hoc, leading to either insufficient protection or overly conservative and costly solutions. Recent approaches using conformal prediction construct data-driven uncertainty sets with finite-sample coverage guarantees, but they still fix coverage targets a priori and offer little guidance for selecting robustness levels. We propose a new framework that provides distribution-free, finite-sample guarantees on both miscoverage and regret for any family of robust predict-then-optimize policies. Our method constructs valid estimators that trace out the miscoverage–regret Pareto frontier, enabling decision-makers to reliably evaluate and calibrate robustness levels according to their cost–risk preferences. The framework is simple to implement, broadly applicable across classical optimization formulations, and achieves sharper finite-sample performance. This paper offers a principled data-driven methodology for guiding robustness selection and empowers practitioners to balance robustness and conservativeness in high-stakes decision-making.

08.
arXiv (quant-ph) 2026-06-15

Spin counting via projection noise measurement of mesoscopic solid-state spin ensemble

arXiv:2606.14437v1 Announce Type: new Abstract: Quantum projection noise is the fundamental noise source for the population measurement of spin ensembles. While projection-noise-limited measurements have been extensively studied in atomic systems, corresponding experiments on solid-state spin ensembles remain challenging due to dominant classical readout noise. Here, we report direct measurement of the quantum projection noise of mesoscopic ensembles of nitrogen-vacancy (NV) spin defects at room temperature. Our experiment is enabled by a high optically-detected magnetic resonance (ODMR) contrast of over 20% for a single crystallographic orientation of the defect spins, obtained by combining polarization-selective optical excitation with spin-to-charge conversion. We use our protocol to demonstrate projection noise measurements and spin counting from nanoscale NV ensembles of up to 43 spins. We further demonstrate that the protocol allows for significant gains in sensitivity for magnetometry applications without need for cryogenic operation or high bias magnetic fields.

09.
arXiv (quant-ph) 2026-06-16

A complexity theory for non-local quantum computation

arXiv:2505.23893v2 Announce Type: replace Abstract: Non-local quantum computation (NLQC) replaces a local interaction between two systems with a single round of communication and shared entanglement. Despite many partial results, it is known that a characterization of entanglement cost in at least certain NLQC tasks would imply significant breakthroughs in complexity theory. Here, we avoid these obstructions and take an indirect approach to understanding resource requirements in NLQC, which mimics the approach used by complexity theorists: we study the relative hardness of different NLQC tasks by identifying resource efficient reductions between them. Most significantly, we prove that $f$-measure and $f$-route, the two best studied NLQC tasks, are in fact equivalent under $O(1)$ overhead reductions. This result simplifies many existing proofs in the literature and extends several new properties to $f$-measure. For instance, we obtain sub-exponential upper bounds on $f$-measure for all functions, and efficient protocols for functions in the complexity class $\mathsf{Mod}_k\mathsf{L}$. Beyond this, we study a number of other examples of NLQC tasks and their relationships.

10.
arXiv (CS.LG) 2026-06-18

Anomaly Detection for Sparse and Irregular Multivariate Time Series with Latent SDEs

arXiv:2606.18898v1 Announce Type: new Abstract: Multivariate time series anomaly detection (MTSAD) is critical for a wide range of application areas, such as industrial monitoring, cybersecurity, or healthcare. Real-world data is often sparse, irregularly sampled or partially observed, yet existing methods assume uniformly sampled time series. We propose a generative approach based on Latent SDEs that projects the observed time series on a continuous-time stochastic dynamical system, directly being able to handle missing observations and irregular sampling, while also naturally capturing possible cyclic behavior that many real-world use cases inherently possess. Experiments on six anomaly benchmark datasets show that our proposed method ranks first among state-of-the-art baselines. We further demonstrate that our method remains robust under severe data sparsity, while performance significantly degrades for the tested baseline methods. These results highlight latent SDEs as a natural inductive bias for anomaly detection in multivariate time series, especially in presence of real-world irregularities.

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

CODA-BENCH: Can Code Agents Handle Data-Intensive Tasks?

Advanced agents are increasingly demonstrating the potential to operate as autonomous engineers, creating a growing demand for evaluation benchmarks that capture the complexity of real-world development. Such environments typically involve both complex code and large-scale data (i.e., file system). However, existing benchmarks usually evaluate code-centric or data-centric capabilities in isolation, leaving a clear gap with real development scenarios. In this paper, we bridge this gap by introducing CODA-BENCH, the first benchmark to jointly evaluate code and data intelligence in a data-intensive environment. We construct a data-intensive Linux sandbox based on the Kaggle ecosystem (containing hundreds of datasets), where agents must actively explore complex file hierarchies to identify relevant resources and generate code for data-driven analytical tasks. CODA-BENCH comprises 1,009 tasks spanning 31 communities, with each task environment containing an average of 980 files, simulating realistic data scale and noise. Evaluations of advanced agents reveal that even top-performing systems struggle to effectively integrate data discovery with code execution, achieving a success rate of only 61.1%. These results highlight a substantial gap in current agentic capabilities for data-intensive tasks and point to promising directions for future research.

12.
arXiv (CS.CV) 2026-06-17

LADBench: A Benchmark for Logical Fault Detection in Images

Large Vision Language Models (VLMs) excel at visual question answering and semantic grounding, but their capacity for autonomous logical reasoning remains underexplored. Existing anomaly benchmarks emphasize visual errors or direct prompting rather than the physical and social common sense needed for open-world deployment. To address this, we introduce LAD-bench, a benchmark of more than 1,000 curated synthetic images with logical anomalies across four domains: Residential, Urban, Collaborative, and Nature. We further propose a Tiered Prompting Protocol based on progressive disclosure, which measures how much explicit assistance a model needs to localize and reason about a logical fault. Evaluating leading foundation models reveals substantial weaknesses: even the best achieves only 70.11% overall accuracy, showing that implicit logical fault detection remains unsolved. Crucially, models often fail to identify anomalies even after receiving explicit hints in deeper tiers. By surfacing these limitations in sequential multimodal reasoning, LAD-Bench offers a rigorous framework for advancing the safety, reliability, and cognitive alignment of autonomous visual systems. Dataset and Code: https://huggingface.co/datasets/SahasraK/LADBench

13.
arXiv (CS.LG) 2026-06-17

Can Vision Foundation Models Navigate? Zero-Shot Real-World Evaluation and Lessons Learned

arXiv:2603.25937v2 Announce Type: replace-cross Abstract: Visual Navigation Models (VNMs) promise generalizable, robot navigation by learning from large-scale visual demonstrations. Despite growing real-world deployment, existing evaluations rely almost exclusively on success rate, whether the robot reaches its goal, which conceals trajectory quality, collision behavior, and robustness to environmental change. We present a real-world evaluation of five state-of-the-art VNMs (GNM, ViNT, NoMaD, NaviBridger, and CrossFormer) across two robot platforms and five environments spanning indoor and outdoor settings. Beyond success rate, we combine path-based metrics with vision-based goal-recognition scores and assess robustness through controlled image perturbations (motion blur, sunflare). Our analysis uncovers three systematic limitations: (a) even architecturally sophisticated diffusion and transformer-based models exhibit frequent collisions, indicating limited geometric understanding; (b) models fail to discriminate between different locations that are perceptually similar, however some semantics differences are present, causing goal prediction errors in repetitive environments; and (c) performance degrades under distribution shift. We will publicly release our evaluation codebase and dataset to facilitate reproducible benchmarking of VNMs.

14.
arXiv (CS.AI) 2026-06-19

Co-policy: Responsive Human-Robot Co-Creation for Musical Performances

arXiv:2606.19914v1 Announce Type: cross Abstract: Art has long stood as a pivotal expression of human creativity. Embodied artificial intelligence offers a route for generative models to participate in that creativity through physical action rather than disembodied digital content. In robotic music co-creation, it is challenging to connect semantic musical understanding with real-time and physically executable performance. We present Co-policy, a framework for human-robot musical co-creation that separates semantic intent grounding, constrained musical variation, and visuomotor execution. To ground musical semantics, Co-policy uses pre-inference semantic anchors and a fine-tuned Qwen-vl planner (F-Qwen) to transform speech, live musical seeds, and visual observations into structured co-creation plans. To support low-latency execution, Co-policy introduces a Gaussian-Mixture Visuomotor Policy (GMP), implemented as a conditional mixture-density policy that maps target notes and visual context to multimodal robot actions in a single forward pass. Unlike robotic playback systems that merely reproduce user-specified notes, Co-policy generates complementary musical responses under both musical and physical constraints. Real-robot chime experiments, ablations, and expert evaluation show improved intent alignment, execution accuracy, and response frequency over diffusion-policy and ablated baselines, supporting physically grounded action generation as a key requirement for embodied human-AI co-creation.

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

Beyond Predefined Schemas: TRACE-KG for Context-Enriched Knowledge Graph Generation

arXiv:2604.03496v2 Announce Type: replace Abstract: Knowledge graph generation typically relies either on predefined ontologies or on schema-free extraction. Ontology-driven pipelines enforce consistent typing but require costly schema design and maintenance, whereas schema-free methods often produce fragmented graphs with weak global organization, especially in long technical documents with dense, context-dependent information. We propose TRACE-KG (Text-dRiven schemA for Context-Enriched Knowledge Graphs), a framework that jointly constructs a context-enriched knowledge graph and an induced schema without assuming a predefined ontology. TRACE-KG captures conditional relations through structured qualifiers and organizes entities and relations using a data-driven schema that serves as a reusable semantic scaffold while preserving full traceability to the source evidence. Experiments show that TRACE-KG produces structurally coherent, traceable knowledge graphs and offers a practical alternative to both ontology-driven and schema-free construction pipelines.

16.
arXiv (CS.LG) 2026-06-17

Instrumental and Proximal Causal Inference with Gaussian Processes

arXiv:2603.02159v2 Announce Type: replace-cross Abstract: Instrumental variable (IV) and proximal causal learning (Proxy) methods are central frameworks for causal inference in the presence of unobserved confounding. Despite substantial methodological advances, existing approaches rarely provide reliable epistemic uncertainty (EU) quantification. We address this gap through a Deconditional Gaussian Process (DGP) framework for uncertainty-aware causal learning. Our formulation recovers popular kernel estimators as the posterior mean, ensuring predictive precision, while the posterior variance yields principled and well-calibrated EU. Moreover, the probabilistic structure enables systematic model selection via marginal log-likelihood optimization. Empirical results demonstrate strong predictive performance alongside informative EU quantification, evaluated via empirical coverage frequencies and decision-aware accuracy rejection curves. Together, our approach provides a unified, practical solution for causal inference under unobserved confounding with reliable uncertainty.

18.
arXiv (CS.AI) 2026-06-19

Mitigating Simplicity Bias in OOD Detection through Object Co-occurrence Analysis

arXiv:2605.07821v2 Announce Type: replace-cross Abstract: Out-of-distribution (OOD) detection is crucial for ensuring the reliability of deep learning models. Existing methods mostly focus on regular entangled representations to discriminate in-distribution (ID) and OOD data, neglecting the rich contextual information within images. This issue is particularly challenging for detecting near-OOD, as models with simplicity bias struggle to learn discriminative features in disentangled representations. The human visual system can use the co-occurrence of objects in the natural environment to facilitate scene understanding. Inspired by this, we propose an Object-Centric OOD detection framework that learns to capture Object CO-occurrence (OCO) patterns within images. The proposed method introduces a new OOD detection paradigm that understands object co-occurrence within an image by predicting disentangled representations for the test sample, then adaptively divides patterns into three scenarios based on object co-occurrence patterns observed in ID training data, and finally performs OOD detection in a divide-and-conquer manner. By doing so, OCO can distinguish near-OOD by considering the semantic contextual relationships present in their images, avoiding the tendency to focus solely on simple, easily learnable regions. We evaluate OCO through experiments across challenging and full-spectrum OOD settings, demonstrating competitive results and confirming its ability to address both semantic and covariate shifts. Code is released at https://github.com/Michael-McQueen/OCO.

19.
arXiv (CS.CL) 2026-06-17

PARSE: Provenance-Aware Retrieval Sanitization for Professional Domain LLM Agents

作者:

Prompt injection defenses evaluated on synthetic benchmarks do not generalize to real enterprise documents, which are longer, denser, and interleave legitimate authority language with factual content. We demonstrate this gap with a real-document benchmark of 122 tasks across five professional domains (financial, legal, medical, scientific, DevOps) using actual SEC filings, Federal Register rules, PubMed abstracts, arXiv papers, and GitHub postmortems. Paraphrasing, the strongest defense on synthetic benchmarks, shows no statistically significant attack success rate reduction on real documents (p=0.500) while degrading utility from 91.8% to 82.8%. We introduce PARSE (Provenance-Aware Retrieval Sanitization), a domain-aware, fact-preserving sanitization pipeline that classifies each sentence by injection likelihood, extracts structured facts before rewriting, and verifies fact preservation via a consistency-checking loop. A directiveness gate routes 59% of real enterprise documents to a lightweight path, concentrating computational cost on high-risk documents. PARSE achieves 15.6% attack success rate – a 38% reduction versus the 25.4% baseline – at 86.9% utility, the only condition that is both statistically significant (p=0.014, adequately powered) and maintains near-baseline utility. Practitioners should evaluate defenses on domain-matched real documents, not synthetic proxies.

20.
arXiv (CS.AI) 2026-06-18

UPLOTS: A Unified Pretrained Language Model for Constrained Time-series Generation

arXiv:2606.10466v2 Announce Type: replace-cross Abstract: In time-series generation, existing approaches typically handcraft ortrain a separate model for each dataset, which hinders their scalability and fails to leverage shared temporal structures across domains. To address this fragmentation, we propose UPLOTS, a Unified, Prompt-guided Language model framework fOr constrained Time-Series Generation across diverse domains. Instead of building task-specific models, UPLOTS leverages a single pre-trained transformer backbone guided by learned constraint prompts, enabling on-demand generation with precise pattern control. One key innovation is our dynamic multi-dataset loss re-weighting and prompt-to-pattern mapping, which allows UPLOTS to internalize diverse temporal structures during training and conditionally generate them at inference. We evaluate UPLOTS on four real-world benchmarks and multiple constraint settings, including peak-period, calendar, load-level, and volatility patterns. Additional held-out constraint-combination and downstream forecasting experiments further demonstrate that UPLOTS generalizes beyond the original peak-pattern setting and improves data augmentation under scarce real-data regimes. Our code and baselines are available at anonymous github repo: https://anonymous.4open.science/r/UPLOTS-6C36.

21.
arXiv (quant-ph) 2026-06-16

Intrinsic preservation of plasticity in continual quantum learning

arXiv:2511.17228v2 Announce Type: replace Abstract: Artificial intelligence in dynamic, real-world environments requires the capacity for continual learning. However, standard deep learning suffers from a fundamental issue: loss of plasticity, in which networks gradually lose their ability to learn from new data. Here we show that quantum learning models naturally overcome this limitation, preserving plasticity over long timescales. We demonstrate this advantage systematically across a broad spectrum of tasks from multiple learning paradigms, including supervised learning and reinforcement learning, and diverse data modalities, from classical high-dimensional images to quantum-native datasets. Although classical models exhibit performance degradation correlated with unbounded weight and gradient growth, quantum neural networks maintain consistent learning capabilities regardless of the data or task. We identify the origin of the advantage as the intrinsic physical constraints of quantum models. Unlike classical networks where unbounded weight growth leads to landscape ruggedness or saturation, the unitary constraints confine the optimization to a compact manifold. Our results suggest that the utility of quantum computing in machine learning extends beyond potential speedups, offering a robust pathway for building adaptive artificial intelligence and lifelong learners.

22.
arXiv (CS.CL) 2026-06-11

Toward Generalist Autonomous Research via Hypothesis-Tree Refinement

Scientific progress depends on a repeated loop of exploration, experimentation, and abstraction. Researchers test candidate directions, interpret the evidence, and carry the resulting lessons into later attempts. We study how an AI agent can run this loop autonomously over long horizons. We introduce Arbor, a general framework for autonomous research that combines a long-lived coordinator, short-lived executors, and Hypothesis Tree Refinement (HTR), a persistent tree that links hypotheses, artifacts, evidence, and distilled insights across time. The coordinator manages global research strategy over the tree, while executors implement and test individual hypotheses in isolated worktrees. As results return, Arbor updates the tree, propagates reusable lessons, refines the search frontier, and admits verified improvements. This design turns autonomous research from a sequence of local attempts into a cumulative process in which strategy, execution, and evidence are carried across time. We evaluate Arbor under Autonomous Optimization (AO), an operational setting where an agent improves an initial research artifact through iterative experimentation without step-level human supervision. Across six real research tasks in model training, harness engineering, and data synthesis, Arbor achieves the best held-out result on all six tasks, attaining more than 2.5x the average relative held-out gain of Codex and Claude Code under the same task interface and resource budget. On MLE-Bench Lite, Arbor reaches 86.36% Any Medal with GPT-5.5, the strongest result in our comparison.

23.
arXiv (quant-ph) 2026-06-17

Time-spectral control of accidental coincidences in daylight entanglement-based free-space QKD

arXiv:2606.17365v1 Announce Type: new Abstract: Daylight entanglement-based free-space quantum key distribution (QKD) is limited by accidental coincidences from receiver-admitted background light. We develop and experimentally validate a receiver-level framework linking receiver bandwidth, accepted temporal width, and background-noise density to Bob singles, sifted-key rate, error rate, and quantum bit error rate (QBER) in telecom-wavelength BBM92 QKD. Indoor sweeps show that useful sifted counts saturate near the source-matched bandwidth, whereas broader bandwidth or higher background mainly increases accidental contamination. Increasing the accepted temporal width leaves Bob singles nearly unchanged but directly raises QBER by enlarging the random-overlap probability. A two-dimensional design map shows that the temporal-window margin contracts rapidly with increasing background-to-signal ratio, while the bandwidth margin remains comparatively broad near source-matched filtering. A 10 m rooftop daylight experiment demonstrates operation in the predicted low-accidental regime, yielding a mean sifted-key rate of 2,811 cps and a mean QBER of 4.43%.

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

Lung-R1: A Knowledge Graph-Guided LLM for Pulmonary Diagnostic Reasoning

arXiv:2606.11675v1 Announce Type: new Abstract: Diagnosing pulmonary diseases requires integrating heterogeneous evidence amid phenotypic variability and cross-disease overlap. Although large language models (LLMs) have shown progress on pulmonary knowledge question answering (QA) and information-processing tasks, reliable pulmonary diagnosis requires patient-specific, relation-aware reasoning over electronic medical record (EMR) evidence rather than isolated knowledge recall. We define this gap between pulmonary knowledge and case-level diagnostic reasoning as the Pulmonary Knowledge-to-Diagnosis Gap. To address it, we introduce LungKG, the first structured pulmonary knowledge graph for diagnostic knowledge organization and record-grounded reasoning. LungKG contains 59,038 nodes and 164,308 edges across 15 entity types and 112 relation types, serving as both a reusable pulmonary knowledge resource and the foundation for LungKG-guided model adaptation. Built on LungKG, we propose Lung-R1, a LungKG-guided pulmonary LLM trained through KG-constrained reasoning-chain construction and KG-guided reinforcement learning. In a 20-system evaluation, Lung-R1-14B achieves state-of-the-art performance across Choice, Pulmonary-QA, and EMR Diagnosis, reaching an EMR Diagnosis score of 4.3583 and surpassing the strongest non-Lung-R1 baseline by 0.1476 points. These results demonstrate the value of LungKG-guided training for EMR-based pulmonary diagnosis.

25.
medRxiv (Medicine) 2026-06-19

Extraction of Glaucoma Diagnosis, Type, and Severity from Clinical Notes using Secure Cloud-based Large Language Models

Purpose: To evaluate the performance of secure cloud-based large language models (LLMs) in extracting glaucoma diagnosis, type, and severity from free-text clinical notes in the electronic health record (EHR). Design: Retrospective chart review analysis. Participants: 1,250 subjects from the Bascom Palmer Ophthalmic Repository. Methods: Clinical notes of glaucoma-related encounters between 2014 and 2024 were extracted from the Bascom Palmer Ophthalmic Repository. Two fellowship-trained glaucoma specialists annotated clinical notes for glaucoma presence, type, and severity at the eye level. The dataset was split into development (10%), validation (10%), and test (80%) sets. Development and validation sets were used for prompt engineering and refinement, and the held-out test set was used for evaluation. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT-5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Azure AI Foundry within HIPAA-compliant containers. Model performance was assessed using standard metrics. Clinician-entered ICD-10 codes were also compared with adjudicated labels. Main Outcome Measures: Gwet AC1, accuracy, sensitivity, specificity, and F1-score. Results: Inter-grader agreement was high for glaucoma detection (Gwet AC1= 0.930 (95% CI: 0.917-0.945), type classification (Gwet AC1= 0.917 (95% CI: 0.904-0.930), and severity staging (Gwet AC1= 0.901 (95% CI: 0.884-0.916). For glaucoma diagnosis, LLMs demonstrated high overall accuracy, with Claude achieving 97.5%, DeepSeek 96.0%, GPT 96.2%, Grok 94.4%, and Qwen 95.5%. F1 scores for glaucoma detection ranged from 95.4% to 98.9% across models. For glaucoma type classification, accuracies were 97.1%, 94.2%, 94.2%, 94.0%, and 94.4% for Claude, DeepSeek, GPT, Grok, and Qwen, respectively. F1 scores for the most prevalent type (POAG) ranged from 96.3% to 98.9%. For severity staging, accuracies were 95.0%, 94.8%, 94.5%, 94.0%, and 95.2%, respectively, with F1 scores ranging from 89.7% to 96.3% across severity categories and models. ICD-10 codes demonstrated substantially lower performance for type and severity staging, with overall accuracies of 89.2% and 58.5%, respectively. Conclusions: Secure cloud-based LLMs accurately extracted glaucoma diagnosis, type, and severity information from free-text ophthalmology notes, achieving performance approaching expert clinician adjudication while substantially outperforming ICD-based phenotyping approaches, particularly for disease severity classification. These findings demonstrate the potential of LLMs to transform unstructured clinical documentation into scalable, research-ready phenotypic data for large-scale glaucoma cohort development and EHR-based ophthalmic research.