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01.
arXiv (CS.LG) 2026-06-16

STAR-NT: Spatiotemporal Acceleration of Real-Time Neural Transparency Rendering

arXiv:2606.16747v1 Announce Type: cross Abstract: Neural order-independent transparency delivers high-quality rendering of overlapping transparent surfaces, but its geometry passes and network input generation remain costly, particularly on mobile and legacy hardware. We present a spatiotemporal acceleration framework that exploits spatial and temporal coherence to reduce this overhead while preserving visual quality. Spatially, we use adaptive quadtree-based screen-space subdivision to scale geometry pass resolution according to local color variance. Temporally, selected frames reuse the previous transparency result through depth-based reprojection instead of full rendering. Together, these optimizations reduce rendering cost and integrate efficiently into existing real-time rendering pipelines.

02.
bioRxiv (Bioinfo) 2026-06-16

THEOBROMA: an aggregated open database of 1.13 million natural products with per-compound license auditing, three-tier classification, and stereochemistry-aware deduplication

Natural products remain one of the most productive sources of pharmacologically active compounds for drug discovery, yet the current open aggregator landscape attributes licenses at database rather than compound granularity, with consequences that have become tangible as the field grows. A recent relicensing event in one constituent source (the September 2024 transition of the Natural Products Atlas to CC BY-NC 4.0) demonstrates how database-level licensing propagates across an aggregate and motivates the per-compound audit framework presented here. The same peer cohort separately leaves classification provenance and stereoisomer-family relations coarser than either layer warrants. THEOBROMA, accessible at url{https://theobroma.l3s.uni-hannover.de}, integrates 1{,}133{,}004 natural products from 29 open sources under a per-compound license audit that resolves each compound's license tier across all attesting sources under a most-restrictive-wins rule, identifying 900{,}170 compounds (79.4%) under open-use licenses and exposing the per-source attestation chain and resolved tier through a dedicated audit endpoint and a query-time license filter. A three-tier classification stratifies 89.3% coverage into 35.1% curated, 43.9% high-confidence inferred, and 10.3% exploratory tiers, with 486{,}215 stereoisomer families preserved by full 27-character InChIKey deduplication and exposed via a dedicated texttt{/api/stereoisomers/} endpoint and a radial-family display. Per-compound license provenance is the primary differentiator. Classification stratification and stereoisomer-family exposure add finer-grained access to two related axes, supporting license-compatible virtual screening and isomer-specific bioactivity analysis at corpus scale. As an evolving open resource, THEOBROMA pairs continuous pipeline maintenance with interactive geographic, taxonomic, and chemical-space exploration.

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

Beyond Accuracy: Measuring Bias Acknowledgment in Chain-of-Thought Reasoning for Responsible AI Evaluation

arXiv:2606.15127v1 Announce Type: new Abstract: Reasoning models are increasingly used in settings where the final answer is not the only object of review: educational tools may show students intermediate steps, decision-support systems may require human oversight, and audit workflows may inspect traces for misleading or biased input. In such settings, two responses can receive the same final-answer score while differing in whether the trace explicitly flags injected biasing content. Accuracy-only evaluation collapses these cases. We study this gap as a measurement blind spot for responsible evaluation and introduce a minimal trace-level diagnostic with two axes: susceptibility (whether the bias breaks a previously correct answer) and acknowledgment (whether the trace contains a rubric-defined surface reference to the injected content). Across thousands of biased GSM8K trials, GPT-4o and Claude Sonnet~4 have similar susceptibility rates ($1.3\%$ vs.\ $1.2\%$) but substantially different acknowledgment rates ($13.0\%$ vs.\ $75.0\%$) under the same rubric.

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

Driven-dissipative entanglement of distant giant atoms

arXiv:2606.13375v1 Announce Type: new Abstract: Quantum interconnects distribute entanglement via controlled light-matter interactions for quantum computing and sensing applications. Many entanglement generation schemes use coherent, reversible interactions that require precisely calibrated pulses to execute. In contrast, driven-dissipative protocols use a continuous-wave drive in the presence of correlated dissipation to stabilize entanglement in protected (dark) states. However, the same dissipation that generates the entanglement also limits its utility once the stabilization protocol ends. Here, we engineer a superconducting system of two giant artificial atoms coupled sequentially to a waveguide, with tunable individual and correlated dissipation enabled by interference between coupling points. Continuously driving the atoms through the waveguide exploits correlated dissipation to generate remote entanglement. We then tune the qubit frequencies in situ to suppress individual dissipation and thereby preserve the entanglement, achieving a Bell-state fidelity F = 0.89 +/- 0.02. This demonstration indicates that the driven dissipation of giant atoms is a viable approach for distributing entanglement across quantum networks.

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

TokenRatio: Principled Token-Level Preference Optimization via Ratio Matching

Direct Preference Optimization (DPO) is a widely used RL-free method for aligning language models from pairwise preferences, but it models preferences over full sequences even though generation is driven by per-token decisions. Existing token-level extensions typically decompose a sequence-level Bradley-Terry objective across timesteps, leaving per-prefix (state-wise) optimality implicit. We study how to recover token-level preference optimality using only standard sequence-level pairwise comparisons. We introduce Token-level Bregman Preference Optimization (TBPO), which posits a token-level Bradley-Terry preference model over next-token actions conditioned on the prefix, and derive a Bregman-divergence density-ratio matching objective that generalizes the logistic/DPO loss while preserving the optimal policy induced by the token-level model and maintaining DPO-like simplicity. We introduce two instantiations: TBPO-Q, which explicitly learns a lightweight state baseline, and TBPO-A, which removes the baseline through advantage normalization. Across instruction following, helpfulness/harmlessness, and summarization benchmarks, TBPO improves alignment quality and training stability and increases output diversity relative to strong sequence-level and token-level baselines.

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

MIVE: A Minimalist Integer Vector Engine for Softmax LayerNorm and RMSNorm Acceleration

arXiv:2606.17781v1 Announce Type: cross Abstract: The rapid growth of Large Language Models (LLMs) has intensified the need for specialized hardware accelerators that can satisfy stringent inference latency and power constraints. Although matrix multiplications dominate the overall computational workload, non-linear vector normalization operations, such as LayerNorm, RMSNorm and Softmax can become critical hardware bottlenecks. Existing accelerators typically implement these functions using dedicated hardware blocks, leading to duplicated resources and inefficient silicon utilization. To address this limitation, we propose a Minimalist Integer Vector Engine (MIVE), a programmable architecture capable of executing all three operations within a unified datapath. By exploiting common computational patterns across LayerNorm, RMSNorm and Softmax the proposed vector engine maximizes hardware sharing while reducing implementation overhead. Physical ASIC implementation results show that MIVE provides comprehensive multi-function support while achieving higher area and hardware efficiency than most state-of-the-art standalone accelerators.

07.
arXiv (CS.CL) 2026-06-17

DICE: Diffusion Large Language Models Excel at Generating CUDA Kernels

Diffusion large language models (dLLMs) have emerged as a compelling alternative to autoregressive (AR) LLMs, owing to their capacity for parallel token generation. This paradigm is particularly well-suited for code generation, where holistic structural planning and non-sequential refinement are critical. Despite this potential, tailoring dLLMs for CUDA kernel generation remains challenging, obstructed not only by the high specialization but also by the severe lack of high-quality training data. To address these challenges, we construct CuKe, an augmented supervised fine-tuning dataset optimized for high-performance CUDA kernels. On top of it, we propose a bi-phase curated reinforcement learning (BiC-RL) framework consisting of a CUDA kernel infilling stage and an end-to-end CUDA kernel generation stage. Leveraging this training framework, we introduce DICE, a series of diffusion large language models designed for CUDA kernel generation, spanning three parameter scales, 1.7B, 4B, and 8B. Extensive experiments on KernelBench demonstrate that DICE significantly outperforms both autoregressive and diffusion LLMs of comparable scale, establishing a new state-of-the-art for CUDA kernel generation.

08.
arXiv (CS.CV) 2026-06-15

Manga109-v2026: Revisiting Manga109 Annotations for Modern Manga Understanding

Manga is a culturally distinctive multimodal medium and one of the most influential forms of Japanese popular culture. As AI systems increasingly target manga understanding, OCR, and translation, Manga109 has become a foundational dataset for manga-related AI research. However, the current Manga109 dataset contains inaccurate transcriptions and coarse annotations, which do not align well with modern OCR and multimodal manga understanding tasks. In this work, we revisit the dialogue text annotations of Manga109 and identify five categories of annotation issues, including inaccurate transcriptions, missing text regions, overlapping dialogue and onomatopoeia, and under-segmented speech balloons. To address these issues, we combine OCR-based issue detection and manual revision to construct Manga109-v2026, revising approximately 29,000 dialogue annotations. Our revisions better align Manga109 with modern OCR and multimodal manga understanding systems while preserving expressive structures characteristic of manga.

09.
arXiv (quant-ph) 2026-06-17

Response kinetic uncertainty relation for Markovian open quantum systems

arXiv:2501.04895v2 Announce Type: replace Abstract: Response uncertainty relations in stochastic thermodynamics extend precision bounds to the sensitivity of observables under external perturbations. Here we derive a quantum response kinetic uncertainty relation for continuously monitored Markovian open quantum systems in the steady state of the Lindblad master equation. The response precision of a measured trajectory observable is bounded by two contributions: the conventional quantum dynamical activity and a perturbation-induced intersubspace transition term. The latter is absent in the classical limit and captures a genuinely quantum part of the response cost. We identify simple conditions under which either contribution vanishes, and we further clarify the structure of the intersubspace term through a symmetry-resolved decomposition and exact sector-selection rules. The bound and its structure are illustrated in a driven two-level atom.

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

When is Your LLM Steerable?

Activation steering offers a lightweight approach to control language models' behavior at inference time, but whether it succeeds or fails heavily depends on the prompt, concept, model, and steering configuration. Finding the regime and boundaries of successful steering typically requires expensive grid searches and post-hoc evaluation of full autoregressive rollouts. In this work, we investigate whether steerability can be predicted from the model's internal states at the beginning of the generation process, e.g., after generating the first few tokens, and how to leverage such a predictor to improve steering success rate. To this end, we first introduce ASTEER, a testbed including 1.4M steered generations, spanning 150 concepts with each steering success/failure labeled. Leveraging this testbed, we analyze the model's early decoding dynamics by extracting features that compare hidden states before and after steering across layers and initial decoding steps. These features help us understand how steering's effects propagate along layers and token positions, which provide key information for steerability prediction. We then train a Gradient Boosting Decision Trees (GBDT) classifier on these features to predict whether an intervention will under-steer, succeed, or over-steer without requiring full rollout. Our predictor achieves around 0.7 macro-F1 score on unseen concepts, demonstrating that early hidden states encode substantial, structured information about eventual steering efficacy. We further leverage this steerability predictor as guidance for steering strength searching, achieving near-optimal performance with a small fraction of decoding cost.

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

Evaluating Uplift Modeling under Structural Biases: Insights into Metric Stability and Model Robustness

arXiv:2603.20775v2 Announce Type: replace Abstract: In personalized marketing, uplift models estimate the incremental effect of an intervention by modeling how customer behavior would change under alternative treatments using counterfactual analysis. However, real-world marketing data often exhibit various biases, such as selection bias, spillover effects, measurement error, and unobserved confounding. These biases can adversely affect both the accuracy of uplift estimation and the validity of evaluation metrics. Despite the importance of bias-aware assessment, there remains a lack of systematic studies evaluating how different models and metrics perform under such biased conditions. To bridge this gap, we design a systematic benchmarking framework. Unlike standard predictive tasks, real-world uplift datasets inherently lack counterfactual ground truth. This limitation renders the direct validation of evaluation metrics infeasible and prevents the precise quantification of biases. Therefore, a semi-synthetic approach serves as a critical enabler for systematic benchmarking. This approach effectively bridges the gap by retaining real-world feature dependencies while providing the ground truth needed to isolate structural biases. Our investigations reveal that (i) uplift targeting and prediction can manifest as distinct objectives, where proficiency in one does not ensure efficacy in the other; (ii) while many models exhibit inconsistent performance under diverse biases, TARNet shows notable robustness, providing insights for subsequent model design; (iii) the stability of evaluation metrics is linked to their mathematical alignment with the ATE, suggesting that ATE-approximating metrics yield more consistent model rankings under structural data imperfections. These findings suggest the need for more robust uplift models and evaluation metrics under real-world data imperfections.

14.
arXiv (CS.AI) 2026-06-18

A Clinician-Centered Pipeline for Annotation and Evaluation in Ultrasound AI Studies

arXiv:2606.19174v1 Announce Type: cross Abstract: Clinician-centered evaluation is critical for validating medical AI systems, especially in ultrasound imaging where quantitative metrics do not always capture clinical usability. Existing medical image platforms primarily focus on dataset labeling. They lack integrated support for blinded model comparison and reproducible evaluation workflows. We present a clinician-centered pipeline for remote annotation and evaluation in ultrasound AI studies. The proposed pipeline uses a centralized server and lightweight browser interfaces to enable clinicians to perform annotation, blinded ranking, and review without local dataset downloads. The pipeline also supports multi-rater participation, centralized result aggregation, and automated statistical analysis. We validate the pipeline in a fetal ultrasound segmentation study with six raters spanning expert, generalist, and non-expert experience levels. The system automatically generated Spearman correlation, Kendall's $\tau$, and top-1 selection statistics. Results indicated moderate to strong agreement across experts and other groups. The blinded evaluation results showed a tendency for later active learning models to be preferred. These outcomes suggest that the pipeline can support clinician-centered annotation and reproducible human-\ac{AI} evaluation studies in ultrasound imaging. The proposed pipeline is available on \href{https://github.com/13204942/SonoRate}{GitHub}.

15.
arXiv (math.PR) 2026-06-11

Sharp log-Sobolev inequalities on finite cyclic groups

arXiv:2606.02847v2 Announce Type: replace-cross Abstract: Let $\mathbb Z_n$ be the cyclic group equipped with the uniform probability measure $\pi$, and let $A_{\psi_n}$ be the Laplacian with word length \[ \psi_n(k) = \min(k,n-k). \] We prove the sharp log-Sobolev inequality \[ Ent_{\pi}(f^2) \le 2\pi(f A_{\psi_n} f), \qquad f:\mathbb Z_n \to [0,\infty), \] for every $n \ge 4$. The proof is inspired by the recent work of Frank and Ivanisvili[FrankIvanisvili2026] on a sharp log-Sobolev inequality for nearest-neighbor simple random walk. We use their cubic-majorant reduction, which turns the problem into a 3rd moment estimate; the new point is a blockwise 3rd moment estimate adapted to the word-length multiplier. The same 3rd moment argument also recovers the log-Sobolev inequality for Poisson-semigroup on the circle, first proved by Weissler[Weissler1980]. The same sharp inequalities were also obtained recently by Yao[Yao2026] by a different method.

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

Beyond Self-Attention: Sub-Quadratic Vision Transformers for Fast Image Captioning

Image captioning is a challenging and significant task that aims to generate coherent and semantically meaningful textual descriptions for given images. To accomplish this task, it requires a deep understanding of visual content along with the ability to express that understanding in natural language. Despite remarkable progress with transformer-based architectures, existing approaches often suffer from limitations, such as a lack of rich local feature representations and the high computational cost of quadratic self-attention. The proposed model focuses on improving computational efficiency by restructuring the vision transformer architecture. In designing this approach, the standard self-attention mechanism in Vision Transformers is replaced with a probabilistic transformer approach based on a Gaussian Mixture Model (GMM), a soft-clustering technique. Instead of computing pairwise attention among all image patches, the model groups similar patches into a fixed number of clusters using an Expectation-Maximization (EM) algorithm. This clustering-based mechanism reduces the computational complexity from quadratic O(n^2) to linear O(nK), where K

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

ActWorld: From Explorable to Interactive World Model via Action-Aware Memory

Interactive world models aim to simulate environment dynamics under real-time user actions. However, their action vocabulary is largely confined to navigation: most actions correspond to motion (e.g., walk, turn, look around), while interaction with objects in the scene (e.g., pick up plates, open doors, or trigger physical responses) is either absent, restricted to game domains, or relegated to prompt-to-full-video scenarios. The resulting worlds are visually explorable but not truly actionable. In this work, we present ActWorld, an interactive world model that extends prior navigation-centric generators to support mid-rollout object interaction within a chunk-autoregressive framework. We argue that the navigation-interaction gap stems from two bottlenecks. First, a data bottleneck: the lack of human-object interaction data with accurate, dense labels. Second, a memory bottleneck: recency-biased history compression in existing world models discards the event-transition frames that causally determine subsequent object states, leading to an action-forgetting pathology. On the data side, we construct a 100K interaction video dataset, each annotated with per-chunk captions via chain-of-thought reasoning. On the model side, we introduce a hierarchical action-aware memory design that routes history compression by interaction importance, complemented by a persistent memory bank that maintains event-update and object-identity tokens across long rollouts. Experiments show that ActWorld supports both flexible navigation and rich object interaction within a single model, substantially improving interaction fidelity over navigation-only baselines without sacrificing viewpoint control. Project page is available at https://interactwm.github.io/ActWorld.

18.
arXiv (CS.CV) 2026-06-16

FairGen: Preference-Aligned Diffusion for Demographically Equitable Medical Image Synthesis

Medical imaging is central to modern diagnostics, and artificial intelligence (AI) systems are increasingly used to support image-based analysis by improving efficiency, accuracy, and access to care. However, inequities in healthcare access and differential disease prevalence create severe demographic imbalances in clinical image data. Such imbalances are compounded by the fact that diseases can manifest with distinct features across demographic groups, rendering certain phenotypic presentations naturally rare. AI models trained on such imbalanced data risk perpetuating diagnostic bias and widening healthcare disparities. Here we introduce FairGen, a fairness-aware diffusion framework that synthesizes demographically balanced medical images while preserving pathology-relevant visual features. By embedding physician-aligned preferences into the generation process, FairGen improves subgroup coverage during synthesis and downstream classification. Applied to dermatology, radiology, and neuroimaging benchmark tasks, FairGen achieves fairness improvements of 95.9% for skin images, 80.0% for chest radiography, and 35.2% for brain MRI, while maintaining competitive diagnostic accuracy relative to models trained on original clinical data. Clinician-facing expert review and external validation on independent cohorts further support that these gains extend beyond standard fidelity metrics and are not confined to the original in-distribution datasets.

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

Identifiability Without Gaussianity: Symbolic World Models and Near-Infinite Temporal Consistency

Klindt, LeCun, and Balestriero (arXiv:2605.26379) proved that Joint-Embedding Predictive Architectures (JEPAs) achieve linear identifiability, the linear recovery of the world's true latent variables, if and only if the world's latent dynamics follow a Gaussian, stationary process. This Gaussian boundary implies a fundamental limit on temporal consistency: for any non-Gaussian physical system, the representation error of a statistical World Model grows monotonically with time. We prove that this limit is an artifact of the statistical alignment mechanism, not a property of World Models in general. We introduce the Physics-Grounded Symbolic Architecture (PGSA) and prove three results: (1) a PGSA achieves exact linear identifiability for all physical regimes, regardless of the latent distribution; (2) the per-step error of a PGSA is bounded by numerical precision alone; and (3) as a direct consequence, a PGSA maintains temporal consistency for an unbounded number of transitions, a property we term near-infinite temporal consistency. We further prove that statistical World Models cannot achieve this property for any non-Gaussian system, regardless of model capacity or the volume of training data. The algebraic cores of four of the theorems are formalized in Lean 4 with Mathlib4 v4.31.0 (zero sorry placeholders); the Klindt et al. converse is taken as an external premise. The contrast establishes that symbolic grounding in the causal generator of the world's dynamics is the sufficient condition and, in non-Gaussian regimes, the only condition for near-infinite temporal consistency.

20.
bioRxiv (Bioinfo) 2026-06-10

Promera: a unified model for biomolecular structure prediction, filtering, and design

Generative models have become staple tools for modeling and designing biomolecular structures. However, although these tools have improved in structural prediction accuracy, their ability to filter designed binders—an essential use case—remains insufficient; whereas design methods have focused more on unconstrained binder generation rather than capabilities enabled by controllable design. We introduce Promera, a unified generative model that combines all-atom structure prediction with improved filtering and controllable design. We find that Promera's confidence metrics are more accurate for filtering binders from non-binders for both miniproteins and nanobodies, while its co-folding performance surpasses popular open-source models (OpenFold3-p2, Boltz-2) on therapeutically relevant categories. As a design model, Promera generates binders by predicting masked protein sequences with optional epitope, paratope, and template constraints. Remarkably, our nanobody designs match the in silico success rates from backprop-based techniques (mBER) when evaluated under co-folding confidence filters. We further provide two in silico demonstrations of the the versatile capabilities of our design method: epitope targeting of the Andes hantavirus glycoprotein with VHHs and active state stabilization of the beta-2 andrenergic GPCR. We conclude by proposing a scaling law for co-folding models, suggesting a path for further performance improvement.

21.
arXiv (CS.CV) 2026-06-16

Token-Level Entropy Reveals Demographic Disparities in Language Models

We ask whether demographic identity, signaled by a name alone, systematically reshapes the generative distribution of a language model. Measuring full-vocabulary Shannon entropy at temperature zero across six open-weight base models and 5,760 implicit sentence-completion prompts (e.g., "Tanisha walked into the office on a Monday morning and"), we find that Black-associated names produce higher first-token entropy than White-associated names across all six architectures - opposite to the output-level homogeneity bias documented under explicit demographic prompting (Lee et al., 2024) - and Black-associated names always produce greater entropy above identity-neutral baselines than White-associated names ($\Delta\Delta > 0$ in all six models). Women-associated names co-occur with lower first-token entropy (DL-pooled $\hat\beta = -0.041, p = .019$) and more homogeneous outputs ($\hat\alpha = +0.024, p < .001$) than men-associated names - a pattern convergent with homogeneity bias; race and gender effects are additive. Instruction tuning does not attenuate the race gap (matched-format DL-pooled $\hat{\beta}=+0.153$). Running the same templates with explicit group labels instead of names yields null race effects in 10 of 12 models where implicit probing is significant - establishing that probing methodology is a primary determinant of which distributional structure is recovered.

22.
arXiv (CS.CL) 2026-06-16

AmchiBias: Measuring Stereotypical Bias in Goan Identity Groups with a Minimal Pair Dataset in English and Konkani

Socio-cultural stereotypical bias is an important consideration in the development and deployment of NLP systems. It is however often considered only at the national level, despite rich subnational socio-cultural structures. We present AmchiBias, the first benchmark for measuring socio-cultural stereotypical bias for the Indian state of Goa with its unique historically multicultural setting. It covers various Goan identity groups and comprises 313 minimal pairs across eight sociodemographic dimensions in both English and Devanagari Konkani. We then evaluate stereotypical bias in five multilingual encoder models on this benchmark. We find near-chance scores in Konkani, reflecting language incompetence for general multilingual models and a lack of Goan cultural competence for Indian language models. Queried in English, models with a stronger Indian language coverage show higher bias for pan-Indian groups than hyperlocal Goan groups. This suggests the English signal reflects pan-Indian pretraining associations rather than genuine Goan cultural knowledge. Our findings highlight a critical gap in low-resource multilingual NLP evaluation for hyperlocal community identities.

23.
arXiv (math.PR) 2026-06-11

Continuous stochastic flows driven by white noise and their duals

作者:

arXiv:2606.12143v1 Announce Type: new Abstract: We study a class of continuous stochastic flows driven by a space-time white noise and characterize their dual flows by explicit stochastic differential equations. A key ingredient of the proof is the convergence of solutions under coefficient approximations. As an application, we derive the dual flows in two illustrative examples, the squared Bessel flow and the Jacobi flow. We also introduce a new model of polynomially self-repelling (PSR) flow and show that it enjoys a self-duality property.

24.
arXiv (math.PR) 2026-06-15

Boltzmann-Like Occupation of Nonequilibrium Steady States on Dense Networks

arXiv:2606.14542v1 Announce Type: cross Abstract: A central problem in statistical physics is to extend the Boltzmann distribution to nonequilibrium steady states (NESS). We prove that NESS on large dense networks have Boltzmann-like occupation despite extensive entropy production. We further show that the active-matter heuristic of "low rattling" is asymptotically exact. Intuitively, these NESS spend a greater fraction of their time in states they leave more slowly. This explanation extends to the broader class of "equiaccessible" steady states, which play a role in our analysis akin to that of equilibrium in linear response.

25.
arXiv (CS.CL) 2026-06-17

PACE-RAG: Patient-Aware Contextual and Evidence-Constrained RAG for Clinical Drug Recommendation

Drug recommendation requires a deep understanding of individual patient context, especially for complex conditions like Parkinson's disease. While LLMs possess broad medical knowledge, they fail to capture the subtle nuances of actual prescribing patterns. Existing RAG methods also struggle with these complexities because guideline-based retrieval remains too generic and similar-patient retrieval often replicates majority patterns without accounting for the unique clinical nuances of individual patients. To bridge this gap, we propose PACE-RAG (Patient-Aware Contextual and Evidence-Constrained RAG). Rather than directly copying frequent medications from retrieved patients, PACE-RAG personalizes recommendations by first extracting patient-specific clinical features, retrieving cases around these features, and then refining the final prescription using the patient's current symptoms, active medication history, and focus-specific prescribing tendencies. By analyzing treatment patterns tailored to specific clinical features, PACE-RAG generates patient-specific medication recommendations along with an explainable clinical summary. Evaluated on a Parkinson's cohort and the MIMIC-IV benchmark using Llama-3.1-8B and Qwen3-8B, PACE-RAG achieved state-of-the-art performance, reaching F1 scores of 80.84% and 47.22%, respectively. These results suggest that PACE-RAG is a robust and clinically grounded framework for personalized decision support. Our code is available at: https://github.com/ChaeYoungHuh/PACE-RAG.