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01.
arXiv (CS.LG) 2026-06-18

Some Complexity Results for Robustness Verification for Binarized Neural Networks

arXiv:2606.18918v1 Announce Type: new Abstract: This paper studies the computational complexity of verification problems for Binarized Neural Networks (BNNs), where activations (and sometimes weights) are binary. We analyze two problems: satisfiability and robustness under uniform image occlusion. We show that BNN satisfiability is NP-complete via a reduction from Boolean satisfiability problem (SAT), and that uniform occlusion induces a piecewise-constant structure in the network output, enabling a polynomial-time robustness-checking algorithm.

02.
arXiv (CS.AI) 2026-06-19

AutoPass: Evidence-Guided LLM Agents for Compiler Performance Tuning

arXiv:2606.20373v1 Announce Type: cross Abstract: Large Language Models (LLMs) show promise for code compilation tasks, but applying them to runtime performance tuning is difficult due to complex microarchitectural effects and noisy runtime measurements. We present AutoPass, a multi-agent framework for compiler performance tuning that uses compiler and runtime evidence to guide LLM-generated optimization decisions. Rather than treating the compiler as a black box like prior auto-tuning schemes, AutoPass opens up the compiler to the LLM, enabling it to query compiler-internal optimization states and analyze the intermediate representation to orchestrate compiler options. The search process iteratively refines optimization configurations using measured runtime feedback to diagnose regressions and guide latency-improving edits. AutoPass operates in an inference-only, training-free setting and requires no offline training or task-specific fine-tuning, making it readily applicable to new benchmarks and platforms. We implement AutoPass on the LLVM compiler and evaluate it on server-grade x86-64 and embedded ARM64 systems. AutoPass outperforms expert-tuned heuristics and classical autotuning methods, achieving geometric-mean speedups of 1.043x and 1.117x over LLVM -O3 on x86-64 and ARM64, respectively.

03.
medRxiv (Medicine) 2026-06-15

Iron deficiency testing among people with incident heart failure in primary care

Background: Given around 50% of people with heart failure have a degree of iron deficiency, guidelines recommend screening. It is uncertain to what extent this is done in primary care and whether testing is equitable. Aim: To report the proportion of people with incident heart failure who undergo a ferritin test within 12 months. Design and setting: Retrospective primary care cohort study using Clinical Practice Research Datalink Aurum data, between 2016 and 2021. Methods: We report the proportion of adults with an incident diagnosis of heart failure who received a ferritin test within 12 months. Multivariable logistic regression was used to examine the odds of testing based on key demographic covariates and co-morbidities. Results: Among 105,749 individuals with an incident diagnosis of heart failure (mean age 71.6 years, SD 14.3), only 35,688 (33.7%) received a ferritin test within the subsequent year. Increasing age (odds ratio 1.25 per 10-year increase, 95% CI: 1.24-1.27), female sex (male sex OR 0.86, 0.84-0.89) and Asian ethnicity (OR 1.70, 1.59-1.80) were all associated with increased odds of testing as were diagnoses of coeliac disease (OR 1.86, 1.58-2.21), type 1 diabetes (OR 1.82, 1.51-2.19) and cirrhosis (OR 1.64, 1.43-1.87). There was geographic variation in testing, even in adjusted analyses. Conclusion: In a large primary care dataset, two thirds of people with incident heart failure did not receive a ferritin test for iron deficiency within a year of diagnosis demonstrating a gap in current practice and an opportunity for improvements in service delivery.

04.
arXiv (quant-ph) 2026-06-12

Measuring Control-Plane Openness in Near-Term Quantum Computing: A Rubric, Its Validation, and an Application to Thirteen Vendor Stacks

arXiv:2605.15233v2 Announce Type: replace Abstract: Public access to pulse-level and control-electronics interfaces in commercial quantum computing has bifurcated. This paper proposes a six-axis rubric for measuring control-plane openness, the layer between gate-level circuit specification and physical control electronics, defined operationally so that the same evidence produces the same grade across vendors. The rubric is validated three ways: a blinded re-grading pass, thirty-nine days after the evidence cutoff, that tests whether the cited evidence and the level definitions alone reproduce the recorded grades; a boundary-case methodology that fixes where each level begins and ends; and a published grading protocol that lets others reproduce and contest any cell. We establish that the rubric measures change rather than describing a snapshot by comparing the catalog against the documented control plane before the February 2025 removal of pulse-level access from IBM hardware, and reporting the cells that moved. The rubric is applied to thirteen commercial vendors across superconducting, trapped-ion, neutral-atom, and photonic modalities as of May 1, 2026, as its first application, and one of the three harms the rubric is designed to detect is demonstrated through a reproduction-access audit of five pre-2025 IBM Qiskit Pulse experiments against the access available on current hardware, carried through to a client-side structural port of the audit's selected target to Rigetti Quil-T. The catalog ships as a separate machine-readable artifact under CC-BY-4.0 with per-cell source URLs (https://doi.org/10.5281/zenodo.20163276). The catalog readings will change as vendor policies shift; the rubric is the contribution that survives them.

05.
arXiv (math.PR) 2026-06-11

Unbiased Derivative Estimation for Stationary Mean of Parameterized Markov chains

arXiv:2606.11487v1 Announce Type: cross Abstract: We propose a new approach to unbiased estimation of the gradients of the stationary means associated with parametrized families of Markov chains. Our estimators are particularly efficient when the Markov chains have slow mixing rate. Our approach does not require a specific parametrization except for an oracle to evaluate the transition density and its gradient at a given data point without any additional knowledge about the density function itself. It makes our estimator suitable for parametrizations associated with neural networks. The estimator can potentially achieve large improvement in terms of efficiency. Numerical experiments confirm the good performance predicted by the theory.

07.
arXiv (CS.AI) 2026-06-12

TWLA: Achieving Ternary Weights and Low-Bit Activations for LLMs via Post-Training Quantization

arXiv:2606.13054v1 Announce Type: cross Abstract: Large language models (LLMs) exhibit exceptional general language processing capabilities, but their memory and compute costs hinder deployment. Ternarization has emerged as a promising compression technique, offering significant reductions in model size and inference complexity. However, existing methods struggle with heavy-tailed activation distributions and therefore keep activations in high precision, fundamentally limiting end-to-end inference acceleration. To overcome this limitation, we propose TWLA, a post-training quantization (PTQ) framework that achieves 1.58-bit weight compression and 4-bit activation quantization while maintaining high accuracy. TWLA comprises three components: (1) Euclidean-to-Manifold Asymmetric Ternary Quantizer (E2M-ATQ) minimizes layer-output error under weight ternarization via a two-stage optimization from Euclidean initialization to manifold relocation; (2) Kronecker Orthogonal Tri-Modal Shaping (KOTMS) applies a Kronecker-structured orthogonal rotation to reshape weights into ternary-friendly tri-modal distributions, while the shared rotation statistically suppresses activation outliers; and (3) Inter-Layer Aware Activation Mixed Precision (ILA-AMP) explicitly introduces adjacent-layer second-order interaction costs in bit allocation and jointly optimizes for the layer-wise disparity of activation quantization gains induced by the shared orthogonal transform, preventing cascades triggered by a few weak layers. Extensive experiments demonstrate that TWLA maintains high accuracy under W1.58A4, while delivering significant inference acceleration. The code is available at .

08.
arXiv (CS.CV) 2026-06-12

Skill-3D: Evolving Scene-Aware Skills for Agentic 3D Spatial Reasoning

This paper explores agentic 3D spatial understanding, i.e., MLLM agents performing 3D reasoning through tool use. Existing methods often misuse tools and exhibit biased tool preferences under 3D scenarios, leaving the agentic paradigm with only marginal gains over non-agentic strategies. We reveal that 3D spatial reasoning tasks are heterogeneous across scenes, while these agents apply a uniform tool-use strategy to all scenes rather than selecting tools according to the specific scene and task. To address this, we propose Skill-3D, a framework that learns self-evolving scene-aware skills. Specifically, Skill-3D identifies the task scene and records the agent's tool-use trajectory into a Scene Memory, where successful trajectories from similar scenes are aggregated and distilled into a reusable scene-aware skill, with failed ones attached to the skill as lessons. During training, once a similar scene recurs, the corresponding skill is injected to guide the agent, producing new trajectories whose successes and failures further refine the skill, forming a loop in which the memory and the skill library co-evolve. Experiments show that Skill-3D substantially improves tool utilization in 3D spatial reasoning (from 39% to 78% on VSI-Bench), driving the agent toward correct and sufficient tool use. For instance, it improves Gemini-3-Flash by 67% on MMSI-Bench. Furthermore, we conduct agentic post-training over skill-guided trajectories, which boosts Qwen3-VL-8B by 60% on VSI-Bench.

09.
arXiv (CS.AI) 2026-06-18

Vibe Coding Ate My Homework: An evaluation of AI approaches to greenfield software engineering and programming

arXiv:2606.18293v1 Announce Type: cross Abstract: Thanks to rapid developments in generative AI, we are in the midst of a paradigm shift that may change how we interact with computers forever. We have observed a growth in the use of natural language prompts to build applications and coding infrastructures without underlying knowledge of the field, and this practice has been dubbed `vibe coding.' It arguably represents what the field of programming has been building towards since the beginning, with every higher level of abstraction that is conceived. Vibe coding promises to be the endpoint for the meta of high-level programming as far as method of input is concerned: eliminating a human's use of code syntax entirely in favour of programming in their mother tongue. This paper aims to evaluate the viability of vibe coding for greenfield software engineering tasks, as well as analyse the benchmarks that have been used to measure its software engineering prowess. To this end, we have developed an evaluation suite for analysing an LLM's proficiency in carrying out simple, isolated greenfield programming tasks in Python to provide scoped insight on the matter.

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

Mirror Descent Beyond Euclidean Stability: An Exponential Separation in Initialization Sensitivity

arXiv:2606.11431v1 Announce Type: new Abstract: Mirror Descent (MD) extends Gradient Descent (GD) beyond Euclidean geometry and has recently reappeared as a lens for KL-regularized policy optimization in reinforcement learning and LLM post-training. This raises a basic robustness question, crucial to reproducibility and reliability: how sensitive are MD dynamics to their inputs? We focus on initialization, often itself a pretrained or previously aligned model. Quadratic-regularized MD, including GD and Mahalanobis geometries, is well-known to be stable for convex smooth objectives. We show a sharp contrast: once the regularizer is non-quadratic, MD can be exponentially more sensitive to initialization than GD, even with a well-conditioned regularizer in Euclidean norm. We give a three-dimensional construction with a convex, smooth objective and a strongly convex, smooth, well-conditioned regularizer where an initial $\varepsilon$ perturbation is quickly amplified to $\min\{polylog^{-1}(1/\varepsilon), \varepsilon e^{\Omega(\eta T)}\}$ after $T$ iterations of MD with step size $\eta$. For canonical KL-regularized MD on the simplex, we show that even linear objectives can amplify an initial $\varepsilon$ perturbation exponentially fast in high-dimensional or near-boundary regimes. Finally, we show that adding a Bregman regularization term toward an anchor point can stabilize the dynamics while largely preserving the optimization guarantees, and that the choice of anchor is crucial: anchoring at the initialization only partially mitigates the instability, whereas anchoring at a fixed point yields a more stable mechanism.

12.
bioRxiv (Bioinfo) 2026-06-13

PertDiffBench: Benchmarking Diffusion Models for Single-Cell Perturbation Response Prediction

Diffusion models are increasingly used to predict transcriptional responses to perturbations, but whether they improve on simpler generative and representation-based baselines remains unclear. Existing evaluations often do not separate the effects of model architecture, input representation, biological context and metric choice, making it difficult to determine where diffusion-based methods are useful. Here we introduce PertDiffBench, a standardized benchmark for diffusion-based transcriptomic perturbation prediction across single-cell and bulk RNA-seq datasets. PertDiffBench evaluates diffusion-based models across three complementary evaluation settings: standard prediction in known single-cell contexts and bulk perturbation conditions, generalization to unseen cell types, species, drugs and intermediate time points, and stress tests of feature dimensionality, input representation, noise type and gene ordering. Across these settings, diffusion models did not show a consistent advantage. scGen remained a strong baseline in common prediction tasks, whereas scDiffusion was the most competitive diffusion-based method in several generalization settings. Temporal imputation showed a different pattern, with a simple DDPM operating directly in expression space outperforming more specialized models. Stress tests showed that performance was model dependent and sensitive to feature dimensionality, encoder choice, noise type and gene ordering. Pretrained encoders did not consistently improve performance, with the classical scVI representation slightly exceeding STATE in seen-condition and unseen-cell-type settings. These results indicate that diffusion-model performance in perturbation response prediction depends strongly on task design and representation choice. PertDiffBench provides a practical framework for evaluating these models under biologically varied and stress-tested conditions.

13.
arXiv (CS.CV) 2026-06-16

A Text Recognition Dataset from Sahidic Coptic Ancient Manuscripts

In this work, we target Handwritten Text Recognition (HTR) in low-resource scenarios, which arise from underrepresented languages, rare scripts, and degraded visual conditions typical of historical documents. We introduce SCAM (Sahidic Coptic Ancient Manuscripts), a new line-level dataset built from digitized ancient manuscripts written in the extinct Sahidic Coptic dialect. The dataset reflects a realistic and challenging setting, as it combines heterogeneous acquisition conditions across libraries with typical manuscript degradations such as ink fading, bleed-through, and material deterioration. In addition to visual complexity, SCAM poses significant linguistic challenges due to the scarcity of resources for Sahidic Coptic, its uncommon alphabet, and dialect-specific diacritics. To support research in low-resource HTR, we benchmark several state-of-the-art approaches based on different paradigms, highlighting their limitations and strengths in this setting. Our results underline the gap between current HTR performance on well-resourced modern scripts and historically grounded, low-resource scenarios, thus providing a reference point for future developments.

14.
PLOS Computational Biology 2026-06-16

Evolution and the ultimatum game: An agent-based model with interbirth intervals and population structure

by Jeffrey C. Schank, Matt L. Miller The ultimatum game (UG) is widely used to study mutually beneficial exchanges, fairness, and prosocial behavior across different societies. However, human behavior in UG experiments does not align with the game-theoretical prediction that proposers should offer the least positive amount and responders should accept such offers. Instead, proposers make generous offers that are greater than the minimum responders are willing to accept, resulting in generous offers with wide offer-acceptance gaps. Numerous evolutionary models of the UG have been created and studied to explain human behavior, particularly generous offers made in UG experiments. These models have recently faced criticism for lacking biological realism and not adequately explaining the data. Here, we present an agent-based model inspired by our hunter-gatherer ancestors and with a biologically more realistic selection process. We assume that (1) agents exist in group-structured and group-clustered populations, where reproduction (2) depends on resource accumulation, but (3) is limited by interbirth intervals. We ran simulations to assess whether this biologically more realistic model evolves patterns of behavior consistent with patterns in the data from meta-analyses of human behavior in the UG. For the proposed model, we show that generous offers robustly evolve, as well as the difficult-to-explain offer-acceptance gaps, only in group-structured populations with interbirth intervals. We demonstrate that these results are robust and may help explain variation in data across societies. We discuss how interbirth intervals interact with group structure to modulate offer and rejection costs, favoring the evolution of generous offers, offer-acceptance gaps, and other patterns in the data on human behavior in the UG. We also discuss why weak selection and/or high mutation rate models cannot explain all the patterns in UG experimental data. We discuss biological realism and conclude that group structure and interbirth intervals may be essential for explaining prosocial behavior across societies.

15.
arXiv (CS.AI) 2026-06-12

Two-Layer Linear Auto-Regressive Models Estimate Latent States

arXiv:2606.12691v1 Announce Type: cross Abstract: Auto-regressive models have emerged as powerful tools for sequential data, from language to video. Understanding how and why these models learn latent representations remains an open theoretical question. In this work, we demonstrate that when trained by empirical risk minimization on data from partially observed linear dynamical systems, two-layer linear auto-regressive models naturally learn to approximate Kalman filtering. In particular, we show that the learned hidden representation coincides, up to a similarity transformation, with the state estimates produced by the optimal (Kalman) filter, even though the model has no explicit knowledge of the underlying dynamics or state. The result follows from three main insights. First, we establish that the Kalman filter is well approximated by an auto-regressive model with bounded truncation error. Second, we show that despite non-convexity, the two-layer optimization landscape is benign, i.e., all stationary points are either strict saddles or global minima. Finally, as our main contributions, we provide finite-sample guarantees on prediction error, parameter estimation error, and latent state recovery. Numerical simulations support the theoretical results and demonstrate that the latent representations of auto-regressive models recover state estimates.

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

CoVEBench: Can Video Editing Models Handle Complex Instructions?

While recent text-guided video editing models excel at elementary tasks (e.g., style transfer, object insertion), real-world user requests are highly compositional. A single prompt often demands multiple coupled edits, such as modifying subjects, actions, and camera views, while strictly preserving unrelated spatiotemporal content. Existing benchmarks, heavily constrained by isolated edits and coarse global metrics, fail to diagnose how models handle such complex workflows. To address this gap, we introduce CoVEBench, a compositional video editing benchmark comprising 416 curated source videos, 626 multi-point editing instructions, and 9,990 fine-grained checklist items. Covering diverse editing dimensions, CoVEBench evaluates models via MLLM-judged instruction compliance and video fidelity, alongside automated metrics for video quality. Extensive experiments reveal that compositional editing remains a profound challenge: current models frequently omit edits, violate preservation constraints, or introduce artifacts when handling multiple operations simultaneously. CoVEBench provides a challenging, diagnostic testbed to advance video editing toward realistic user workflows.

17.
Nature (Science) 2026-06-10

Building user-driven climate adaptation products

Climate adaptation products have traditionally been developed using a supply-driven model reliant on available climate information, leading to usability gaps1–4. To better meet user needs, the climate services field has recognized a need to shift towards a demand-driven model emphasizing co-production, that is, user-driven, scientifically informed products created through shared knowledge practices1–5. However, co-production can be challenging, especially for researchers unfamiliar with the approach or for digital and software-based products with complex user needs2,5–8. User-centred design, from the human–computer interaction field, offers a process that could complement co-production approaches to product development, yet its potential remains underexplored2. Here we show how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products. Through a systematic review of the co-production and user-centred design literature, we identify key processes, mechanisms and best practices for both approaches. Our findings offer practical guidance for researchers and propose an integrated approach for developing climate adaptation products that are useful, usable and used. A systematic review and analysis shows how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products.

18.
arXiv (CS.LG) 2026-06-17

QueryMarket: Cost-Aware Online Active Learning in Data Markets

arXiv:2606.17805v1 Announce Type: new Abstract: Data acquisition is a major bottleneck for learning in real-time streams: analysts must decide on the fly which labels to purchase while respecting a rolling budget. However, existing online active learning rarely unifies pricing, information gain, and rolling budget constraints under concept drift. We introduce QueryMarket, a market-inspired framework that queries each incoming data point based on its estimated utility to the model and its price. Within this framework, we propose OVBAL (online variance-based active learning), which integrates data pricing with information-driven selection by estimating each sample's marginal utility via a D-optimality criterion with exponential forgetting and executing cost-aware purchases under rolling budget constraints. OVBAL yields a simple, fully online decision rule that adapts to nonstationary streams and heterogeneous label costs. Experiments on synthetic data and a real-world solar power generation forecasting task show that OVBAL is particularly effective under seller-centric pricing and yields a more favorable long-run error-cost trade-off in the real-world task under both pricing schemes.

19.
Nature Biotechnology 2026-06-23

Efficient generation of epitope-targeted antibodies with Germinal

Obtaining antibodies to specific protein targets is a widely important yet experimentally laborious process. Meanwhile, computational methods for antibody design have been limited by low success rates that require resource-intensive screening. Here we introduce Germinal, a broadly enabling generative pipeline that designs antibodies against specific epitopes with nanomolar binding affinities while requiring only low-n experimental testing. Our method co-optimizes antibody structure and sequence by integrating a structure predictor with an antibody-specific protein language model to perform de novo design of functional complementarity-determining regions onto a user-specified structural framework. When tested against four diverse protein targets, Germinal designed functional antibodies across all targets and binder formats, testing only 43–101 designs for each antigen. Validated designs also exhibited robust expression in mammalian cells and high sequence and structural novelty. We provide open-source code and full computational and experimental protocols to facilitate wide adoption. Germinal achieves epitope-targeted, de novo complementarity-determining region design with high experimental success rates.

20.
arXiv (CS.CL) 2026-06-12

A Context-Aware Dataset for Stance Detection in Bioethical Controversies on Reddit

Bioethical debates increasingly unfold on social media, yet stance detection research lacks large-scale, domain-specific resources for modeling such context-dependent discourse. We present BioStance, a context-aware dataset of 39,600 annotated Post-Comment pairs from Reddit bioethical discussions. BioStance covers six controversial targets across three dimensions of bioethical controversy: fundamental value conflicts, individual liberty versus collective responsibility, and technological uncertainty. Each instance preserves hierarchical conversational context and is labeled by three independent annotators using a three-class stance scheme: Favor, Against, and None. The annotations achieve a mean Krippendorff's $\alpha$ of 0.82, indicating substantial reliability. By combining thematic diversity, conversational structure, and high-quality human annotation, BioStance supports research on context-aware stance detection, argument mining, and computational analysis of bioethical discourse.

21.
arXiv (CS.AI) 2026-06-17

PLATE: Plasticity-Tunable Efficient Adapters for Geometry-Aware Continual Learning

arXiv:2602.03846v2 Announce Type: replace-cross Abstract: We develop a continual learning method for pretrained models that requires no access to old-task data, addressing a practical barrier in foundation model adaptation where pretraining distributions are often unavailable. Our key observation is that pretrained networks exhibit substantial geometric redundancy, and that this redundancy can be exploited in two complementary ways. First, redundant neurons provide a proxy for dominant pretraining-era feature directions, enabling the construction of approximately protected update subspaces directly from pretrained weights. Second, redundancy offers a natural bias for where to place plasticity: by restricting updates to a subset of redundant neurons and constraining the remaining degrees of freedom, we obtain update families with reduced functional drift on the old-data distribution and improved worst-case retention guarantees. These insights lead to \textsc{PLATE} (Plasticity-Tunable Efficient Adapters), a continual learning method requiring no past-task data that provides explicit control over the plasticity-retention trade-off. PLATE parameterizes each layer with a structured low-rank update $\Delta W = B A Q^\top$, where $B$ and $Q$ are computed once from pretrained weights and kept frozen, and only $A$ is trained on the new task. The code is available at https://github.com/SalesforceAIResearch/PLATE.

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

VitalAgent: A Tool-Augmented Agent for Reactive and Proactive Physiological Monitoring over Wearable Health Data

arXiv:2605.29483v2 Announce Type: replace Abstract: Wearable devices enable continuous monitoring of physiological signals such as ECG and PPG, but existing mHealth systems are largely limited to task-specific prediction pipelines or reactive question answering over static summaries. They lack the ability to support temporal reasoning, persistent physiological context, and proactive monitoring over long-term signal streams. We propose VitalAgent, a tool-augmented agentic framework for ECG/PPG-based mHealth that supports both reactive question answering and proactive monitoring. VitalAgent is built on a longitudinal physiological memory and a tool-augmented reasoning interface that enables dynamic computation over raw signals. We further introduce VitalBench, a longitudinal physiological monitoring benchmark dataset comprising 1,862 QA pairs for reactive question answering and 90.2 hours of continuous ECG/PPG recordings for proactive monitoring, covering cardiac, physical activity, and stress-related tasks. Experiments demonstrate that VitalAgent achieves over 25% improvement over prompt-based and ReAct baselines in reactive evaluation and supports proactive alert monitoring over long-term physiological signals, highlighting the importance of dynamic tool use and long-term physiological monitoring.

23.
arXiv (quant-ph) 2026-06-11

A Geometric Family of Correlations Containing the Quantum Singlet

arXiv:2606.12045v1 Announce Type: new Abstract: We introduce a geometrically constrained hidden-variable framework that generates a family of correlations parametrized by a boundary function, within which the quantum singlet correlation appears as a particular member. Exact expressions for the correlation function are derived. Several structural results are established, including admissibility conditions, symmetry properties, a universal stationary point of the associated CHSH function, and an exact relation between the CHSH value at $\nu=\pi/4$ and a geometric contrast measure defined on the underlying hidden-variable distributions. Rather than treating the quantum singlet correlation as an isolated target to be reproduced, the present framework places it within a broader geometric structure of correlations. These results suggest the existence of a nontrivial geometric structure underlying the family of correlations and motivate the search for a principle capable of selecting the quantum singlet solution from within that family.

25.
arXiv (CS.CL) 2026-06-16

Transfer Learning for FHIR Questionnaire Terminology Binding

Electronic prior authorization workflows require FHIR Questionnaire items to carry LOINC codes, yet most items in the HL7 Da Vinci CDS-Library lack these bindings. We treat this as a retrieval problem: given a Questionnaire item's text, find the correct LOINC code in a pool of 97,314 active codes. We compare six methods (TF-IDF, frozen MiniLM, BioBERT, BioLORD, contrastively fine-tuned MiniLM, and a TF-IDF+GPT reranker) on a 54-item evaluation set spanning three query styles (natural question, medium, and terse). No single method wins on every metric. BioLORD, a frozen encoder pre-trained on biomedical ontology definitions, has the best top-rank accuracy (R@1 = 0.185, MRR = 0.246) despite seeing no task-specific data, while a contrastive fine-tune on raw LHC-Forms pairs takes R@5 (0.389) and R@10 (0.426). A distribution-shift ablation shows why the fine-tune in our main table is not the strongest one: adding GPT-generated paraphrases to the raw pairs drops R@5 from 0.389 to 0.296, so the augmented union underperforms raw-only training on every metric except R@1. Performance peaks at 5k training pairs. Error analysis on BioLORD's R@1 failures shows that wrong-specificity and ambiguous-text cases together account for 59% of errors.