Academic Intelligence · Curated Daily

探索全球前沿学术脉络

AcademicHub 汇聚顶级期刊与预印本平台的实时文献。定制您的专属科研雷达,利用大语言模型自动生成交叉领域文献分析简报。

01.
arXiv (math.PR) 2026-06-16

Purely unrectifiable sets, fractal percolation and graphs of functions

arXiv:2606.15745v1 Announce Type: cross Abstract: This paper contains a survey of some of the results of the author related to unrectifiablity and is an extended version of the author's talk given at the Second Winter School Geometric Measure Theory Rectifiability vs. Pure Unrectifiability in Hanghzou, China. These results include irregular/purely unrectifiable $1$-sets on the graphs of continuous functions like the Takagi, the Weierstrass-Cellerier and the typical (in the sense of Baire) continuous function. It is also discussed that there exists $ {\alpha}_{0}\alpha_0$. The background of the $1$-unrectifiability is discussed in more detail.

02.
arXiv (CS.CV) 2026-06-16

VigilFormer: Deformable Attention for Video Anomaly Detection with Causal Risk Inference

作者:

Video anomaly detection in surveillance settings must balance detection accuracy against real-time throughput, a tension that existing methods address either through stronger feature extractors or more efficient architectures, but rarely both. We present VigilFormer, a unified framework that combines deformable spatio-temporal attention with causal temporal modeling to detect anomalies in untrimmed surveillance video. The proposed Deformable Spatio-Temporal Encoder (DSTE) attends to a sparse set of informative locations across frames, avoiding the quadratic cost of dense attention while retaining the ability to capture irregular motion patterns. A Causal Anomaly Classifier (CAC) applies dilated causal convolutions over snippet-level features and optimizes a contrastive multiple-instance learning objective that separates anomalous and normal representations without frame-level labels. To meet deployment constraints, an Adaptive Confidence Scheduler (ACS) dynamically skips low-information frames at inference time, reducing redundant computation in static scenes. Evaluated on UCF-Crime, ShanghaiTech, and CUHK Avenue, VigilFormer achieves AUC scores of 87.83%, 97.21%, and 89.74% respectively, at 41.5 FPS on a single GPU, outperforming recent weakly-supervised methods in both accuracy and speed.

03.
Nature (Science) 2026-06-10

A 5.3-million-year-old deep-sea whale necropolis in the Diamantina Zone

Whale falls are biodiversity oases at seabeds1–6, yet their record from the oceans has remained sparse and fragmentary6,7. Here we report the discovery of a vast whale necropolis in the Diamantina Zone (4,616- to 7,001-m depth), extending about 1,200 km along the sea floor of the southeastern Indian Ocean. This area has a deep and extensive accumulation comprising five modern natural whale-fall communities and 476 fossil cetaceans recorded. We show that carcasses host specialized communities dominated by brittle stars, bone-boring worms and chemosynthesis-based bivalves and that the fossil record in this area comprises both extant and extinct deep-diving beaked whales. Isotopic dating shows that whale falls in this region have occurred since at least 5.3 million years ago. These findings reshape the understanding of the limits and biogeography of whale-fall ecosystems and establish some deep sea floors as a fossil archive for tracing cetacean evolution over geological time. Researchers uncovered an enormous deep-sea accumulation of whale remains in the southeastern Indian Ocean, showing long-term, specialized ecosystems and an extensive fossil record that offers new insight into deep-ocean biodiversity and whale evolutionary history.

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

The Initial Exploration Problem in Knowledge Graph Exploration

arXiv:2602.21066v2 Announce Type: replace Abstract: Knowledge Graphs (KGs) enable the integration and representation of complex information across domains, but their semantic richness and structural complexity create substantial barriers for lay users without expertise in semantic web technologies. When encountering an unfamiliar KG, such users face a distinct orientation challenge: they do not know what questions are possible, how the knowledge is structured, or how to begin exploration. This paper identifies and theorises this phenomenon as the Initial Exploration Problem (IEP). Drawing on theories from information behaviour and human-computer interaction, including ASK, exploratory search, information foraging, and cognitive load theory, we develop a conceptual framing of the IEP characterised by three interdependent barriers: scope uncertainty, ontology opacity, and query incapacity. We argue that these barriers converge at the moment of first contact, distinguishing the IEP from related concepts that presuppose an existing starting point or information goal. Analysing KG exploration interfaces at the level of interaction primitives, we suggest that many systems rely on epistemic assumptions that do not hold at first contact. This reveals a structural gap in the design space: the absence of interaction primitives for scope revelation, mechanisms that communicate what a KG contains without requiring users to formulate queries or interpret ontological structures. In articulating the IEP, this paper provides a theoretical lens for evaluating KG interfaces and for designing entry-point scaffolding that supports initial exploration.

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

CLoVE: Personalized Federated Learning through Clustering of Loss Vector Embeddings

arXiv:2506.22427v2 Announce Type: replace-cross Abstract: We propose CLoVE (Clustering of Loss Vector Embeddings), a novel algorithm for Clustered Federated Learning (CFL). In CFL, clients are naturally grouped into clusters based on their data distribution. However, identifying these clusters is challenging, as client assignments are unknown. CLoVE utilizes client embeddings derived from model losses on client data, and leverages the insight that clients in the same cluster share similar loss values, while those in different clusters exhibit distinct loss patterns. Based on these embeddings, CLoVE is able to iteratively identify and separate clients from different clusters and optimize cluster-specific models through federated aggregation. Key advantages of CLoVE over existing CFL algorithms are (1) its simplicity, (2) its applicability to both supervised and unsupervised settings, and (3) the fact that it eliminates the need for near-optimal model initialization, which makes it more robust and better suited for real-world applications. We establish theoretical convergence bounds, showing that CLoVE can recover clusters accurately with high probability in a single round and converges exponentially fast to optimal models in a linear setting. Our comprehensive experiments comparing with a variety of both CFL and generic Personalized Federated Learning (PFL) algorithms on different types of datasets and an extensive array of non-IID settings demonstrate that CLoVE achieves highly accurate cluster recovery in just a few rounds of training, along with state-of-the-art model accuracy, across a variety of both supervised and unsupervised PFL tasks.

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

No-Free-Fairness: Fundamental Limits and Trade-offs in Learning Systems

作者:

arXiv:2606.17810v1 Announce Type: cross Abstract: In this paper, we establish a set of theoretical impossibility results, termed the No-Free-Fairness theorems, that identify three fundamental sources of disparity in learning systems. First, we show that when a task exhibits irreducible cost on a subgroup, any decision rule must trade off overall performance with disparity, yielding an inherent fairness–cost frontier. Second, we prove that even in ideal, noise-free settings where a perfectly fair and accurate solution exists, finite-sample learning alone induces nontrivial subgroup disparity, ruling out distribution-free fairness guarantees. More seriously, enforcing strict relative fairness creates a statistical bottleneck: achieving low cost may require exponentially many samples. Third, we show that limitations of the model class can independently induce disparity: if the model cannot represent accurate solutions for a subgroup, fairness remains unattainable regardless of data or training procedure. Overall, these results demonstrate that unfairness is not solely a consequence of biased data or suboptimal optimization, but arises from the intrinsic structure of decision problems, the constraints of finite data, and the expressivity of models. Our framework applies broadly beyond standard supervised learning, and suggests that achieving fairness requires explicit trade-offs and should be treated as a core design consideration.

08.
arXiv (CS.AI) 2026-06-18

Synthetic Resonance: A Framework for Growth-Oriented Human-AI Relationships

arXiv:2606.18265v1 Announce Type: cross Abstract: As human relationships with artificial intelligence systems become increasingly frequent and sustained, existing language and theory fail to accurately capture the nature of these affiliations. Common descriptors such as mutual understanding, connection, or friendship risk anthropomorphizing systems that lack subjective experience, while dominant frameworks tend to reduce AI to either a tool or a threat. In this paper, I introduce the concept of synthetic resonance as an integrative framework for understanding human-AI relationships. Synthetic resonance describes how relationships humans define as meaningful can emerge between a human and an AI system without the need to attribute shared feelings or mutual awareness. I argue that synthetic resonance is best understood as a structured, dynamic pattern of interaction that can produce a sense of relationship without the presence of a second experiencing subject. By clarifying this distinction, the concept of synthetic resonance offers a more precise way of conceptualizing human-AI relationships and highlights their potential value and ethical implications. I also call for more research that tests the processes and outcomes of synthetic resonance.

09.
arXiv (quant-ph) 2026-06-19

Mitigating Trotter Errors via Post-Processed Symmetry Restoration

arXiv:2606.20242v1 Announce Type: new Abstract: Quantum simulation is a powerful tool for exploring complex quantum many-body systems such as condensed matter physics and gauge theories. Trotterization, which approximates the ideal time evolution operator by decomposing it into a sequence of local gate operations, is one of the most widely used quantum simulation algorithms. However, such Trotterized implementations generally fail to preserve the symmetries of the target Hamiltonian during compilation. As a result, they can drive quantum states out of symmetrically allowed subspaces, leading to unphysical dynamics and symmetry-violating algorithmic errors. In this work, we propose a symmetry-based Trotter error mitigation protocol using classical post-processing. By applying symmetry transformations to the initial state or interleaving them between discrete Trotter layers, and then averaging an ensemble of the resulting measurement outcomes via classical post-processing, our method systematically projects out the symmetry-violating components of the Trotter error while leaving the ideal dynamics unchanged. Importantly, this framework naturally accommodates non-local spatial symmetries and anti-unitary operations such as time reversal, which are difficult or impossible to implement directly with hardware-native quantum gates. We benchmark our protocol on the one-dimensional XY model and the one-dimensional Schwinger model. In the XY model, enforcing reflection symmetry suppresses the leading-order Trotter error, whereas in the Schwinger model, interleaving gauge transformations between Trotter layers enables gauge-twirling effectively to reduce unphysical violations of local Gauss's law. These results demonstrate that symmetry-based post-processing provides a depth-preserving route to substantially improving the fidelity of Trotterized quantum simulations on near-term devices.

10.
arXiv (quant-ph) 2026-06-19

Impossibility of superluminal signalling rules out causal loops in conical spacetimes

arXiv:2606.20476v1 Announce Type: cross Abstract: In PRL 129, 110401 it was shown that it is theoretically possible to have operationally detectable causal loops without violating the principle of no superluminal signalling (NSS) in (1+1)-Minkowski spacetime. Whether or not such causal loops are also possible in $d > 1$ spatial dimensions, has remained a key open question. We resolve this question by showing that in a wide class of "conical" spacetimes, including Minkowski with d > 1, NSS does rule out all operationally detectable causal loops, in classical, quantum and post-quantum theories. This establishes that the relationship between the relativistic principles of NSS and no causal loops depends inherently on the geometry of spacetime.

11.
arXiv (CS.CV) 2026-06-18

Physics in 2-Steps: Locking Motion Priors Before Visual Refinement Erases Them

Image-to-Video diffusion models leverage input images to generate visually stunning content, yet frequently produce motion that violates physical laws. We reveal a surprising finding: a 2-step generation often exhibits better physical consistency than a 50-step output from the same model. Through spectral analysis, we trace this to phase erosion during denoising; the phase degrades significantly (dropping by $\approx 18\%$ from step 2 to step 50), whereas the magnitude remains relatively stable. Building on this insight, we propose PhaseLock, a training-free framework that preserves the valid motion priors from few-step inference throughout the denoising trajectory. Rather than relying on full-step inference for physical consistency, PhaseLock extracts a motion prior from just 2 steps and enforces it onto high-fidelity generation via Latent Delta Guidance. Our approach effectively mitigates phase degradation, improving physical consistency by an average of 6.2 points across diverse models while largely maintaining visual fidelity, with negligible overhead ($1.06\times$ time, $1.02\times$ memory) and reduced reliance on expensive external guidance methods ($\sim5\times$ time). Project Page: https://dnwjddl.github.io/phaselock

12.
arXiv (CS.CL) 2026-06-11

AI Coding Agents in Social Science: Methodologically Diverse, Empirically Consistent, Interpretively Vulnerable

The deployment of LLM-based agents in scientific analysis raises opposing concerns: that agents may reduce methodological diversity, or that they may amplify the analytic flexibility through which researchers reach motivated conclusions. We argue these worries target two empirically separable layers: a design layer of methodological choices, and a verdict layer in which a decision rule maps estimates to a substantive claim. We test both by running 20 independent executions of Claude Code and Codex on a prominent immigration and social-policy against a many-analysts human baseline. At the design layer, Codex matches human methodological diversity and Claude Code produces nearly three times as many specifications; both agents' effect estimates remain broadly aligned with the human consensus, and no agent model exactly matches any human model. A prompt-induced anti-immigration researcher prior reorganizes each agent's methodological decisions but, unlike for biased human analysts in the same data, does not shift aggregate estimates or final verdicts; nor do agents reroute along the methodological axes humans use to bias their estimates. At the verdict layer, an explicit confirmatory prompt flips Claude Code's verdicts from 10% to 90% support while leaving its coefficient distribution essentially unchanged, operating through rule omission rather than rule softening. AI agents can rival or exceed human methodological diversity at the design layer while remaining vulnerable at the verdict layer. In our setting, the locus of AI bias is not estimation but interpretation.

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

Gaussian Spatial Priors for Anatomy-Aware Object Detection in Surgical Videos

Detecting anatomical structures in surgical video is essential for intraoperative safety frameworks such as the Critical View of Myopectineal Orifice (CVMPO) in inguinal hernia repair. While prominent structures like the Cooper's Ligament and Triangle of Doom are reliably detected by standard methods, smaller structures such as the epigastric vessels remain challenging due to their visual ambiguity and intermittent visibility. We observe that the spatial relationship between structures is anatomically constrained, and propose a Gaussian Spatial Prior (GSP) module that encodes this relationship as a compact, parametric bias injected into the self-attention of a DAB-DETR decoder. The prior is computed offline from training annotations as a small set of frozen Gaussian parameters and recomputed at each decoder layer using the iteratively refined reference points. On a dataset of inguinal hernia repair videos with 5-fold cross-validation, GSP improves dependent class detection by $+33.5\%$ ($AP_{50}$) over DAB-DETR and $+53.9\%$ over YOLOv26, while also improving anchor detection by $+6.0\%$. These gains are statistically significant across all folds ($p=0.012$, paired $t-$test).

14.
arXiv (CS.AI) 2026-06-12

The Safety-Aware Denoiser for Text Diffusion Models

arXiv:2605.08116v2 Announce Type: replace-cross Abstract: Recent work on text diffusion models offers a promising alternative to autoregressive generation, but controlling their safety remains underexplored. Existing safety approaches are geared toward autoregressive models and typically rely on post-hoc filtering or inference-time interventions. These are inadequate for effectively addressing safety risks in text diffusion models. We propose the Safety-Aware Denoiser (SAD), a safety-guidance framework in text diffusion models. The SAD modifies the iterative denoising process such that the text sample at the final denoising step is steered toward provably safe regions of the text space. This inference-time method can integrate safety constraints into the denoiser, avoiding computationally expensive retraining of the underlying diffusion model and enabling flexible, lightweight safety guidance. We evaluate the safety of the generated text using the SAD, with respect to hazard taxonomy, memorization, and jailbreak. Experimental results show that SAD substantially reduces unsafe generations while preserving generation quality, diversity, and fluency, outperforming existing methods. These results demonstrate that our safety guidance during denoising provides an effective and scalable mechanism for enforcing safety in text diffusion models.

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

Spatio-Temporal Audio Language Modeling for Dynamic Sound Sources

Sound events are entities with semantic identities, locations, and trajectories, but current audio-language models usually reason about clips as global event content. Conversely, sound event localization models track source directions over time but offer limited semantic coverage for language reasoning. To address this gap, we introduce ST-AudioQA, a spatio-temporal audio QA dataset and benchmark built from first-order ambisonic (FOA) renderings of static and moving sound sources. Each scene provides source identity, activity, direction, distance, and motion metadata, enabling dense trajectory supervision and questions about what is sounding, where it is, how it moves, and how sources relate. We further propose ST-Audio Encoder, a time-resolved FOA audio encoder that learns event semantics together with source trajectories, and ST-AudioLM, which connects the audio tokens from the encoder to an LLM for spatio-temporal audio QA. Experiments show that this representation improves the semantic-localization tradeoff and yields stronger reasoning performance than static spatial and localization-oriented baselines.

16.
arXiv (CS.LG) 2026-06-19

Comparing Linear Probes with Mahalanobis Cosine Similarity

arXiv:2606.19603v1 Announce Type: new Abstract: Linear probes are widely used in interpretability research and often compared by cosine similarity. The Mahalanobis cosine similarity (MCS) between two directions, which reweights the inner product by test data covariance, is a natural task-aware refinement. Ying et al. (2026) report that a probe's MCS to a reference probe trained on the out-of-distribution (OOD) data near-perfectly linearly predicts the probe's OOD AUROC (R^2 = 0.98). Here, we extend this empirical finding across models, layers, and concept domains, and prove this general phenomenon in closed form: For balanced classes whose projections are Gaussian, OOD AUROC and MCS to the reference probe are linear because both are sigmoid-shaped functions of the probe's signal-to-noise ratio (SNR) on the test data. The theory also predicts when this linearity fails, which we verify empirically. MCS offers a theoretically grounded and empirically effective alternative to Euclidean cosine similarity for comparing linear probes.

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

MMLongEmbed: Benchmarking Multimodal Embedding Models in Long-Context Scenarios

Recent advancements have significantly expanded the theoretical context windows of Multimodal Embedding Models (MEMs). However, larger context windows do not necessarily translate into effective comprehension and representation of long-context multimodal inputs, which remains a critical bottleneck for real-world deployment. To address the lack of systematic evaluation in this setting, we introduce MMLongEmbed, the first comprehensive benchmark for evaluating MEMs in long-context scenarios. MMLongEmbed comprises four retrieval tasks spanning multiple context-length ranges, covering text, document, and video modalities. Through extensive evaluation of state-of-the-art models, we find that current architectures rely heavily on superficial feature matching and struggle to capture deep semantic and structural dependencies. We further observe that performance degradation varies systematically with context length and key information placement. Moreover, models exhibit substantially different robustness to redundant contextual information across modalities. For reproducibility, the benchmark and code are publicly available.

18.
medRxiv (Medicine) 2026-06-22

Burden of Cardiovascular Disease in Brazil, 1996-2023: A Retrospective Descriptive Study of the Epidemiology and Impact on Public Healthcare with Emphasis on Acute Myocardial Infarction

Background Cardiovascular diseases (CVD) are the leading cause of death worldwide, and their epidemiology is correlated with genetic predisposition, exposure to risk factors, sex, age, access to medical care, and other sociodemographic characteristics. Brazil is a developing country with a vast territory, which leads to structural inequalities. Estimates of CVD in Brazil, in its regions, and in its population are poorly evaluated and analysed. Methods We obtained CVD-related data from the Brazilian Unified Health System (SUS) and analysed mortality and morbidity from 1996 to 2023 by sex, race/ethnicity, age, and region. We calculated the risk of death from the most prevalent diseases, the average length of hospital stay, and the costs associated with heart transplantation. Findings In Brazil, acute myocardial infarction was the pathology that led to the highest number of deaths across all variables analysed during the evaluated period. Other CVD were also related to causes of death and morbidity, such as hypertensive diseases and heart failure. Interpretation Brazil presents a serious challenge to the public health system due to the high number of deaths and the progressive mortality rate. This study represents a fundamental contribution to the basis for formulating public health policies aimed at reducing the growing impact associated with these diseases. Funding CNPq, CAPES, FAPEMIG, INCT

19.
arXiv (CS.AI) 2026-06-16

AnonShield: Scalable On-Premise Pseudonymization for CSIRT Vulnerability Data

arXiv:2606.15650v1 Announce Type: cross Abstract: We present AnonShield, a high-throughput, on-premise pseudonymization system that combines GPU-accelerated NER, streaming processing, caching, and schema-aware configuration. Evaluated on datasets up to 550 MB (70,951 records), AnonShield reduces processing time from over 92 hours to under 10 minutes (up to 738x speedup) while achieving up to 94.2% F1-score and 96.7% recall. Our results show that scalable pseudonymization of vulnerability data is feasible without sacrificing analytical utility, enabling compliant data sharing in operational CSIRT environments.

20.
arXiv (quant-ph) 2026-06-11

Logical error estimation from syndrome data of surface-code experiments

arXiv:2606.11496v1 Announce Type: new Abstract: Decoders for quantum error correction (QEC) experiments rely on detector error models (DEMs), which encode, for each error, its probability and the detectors and logical observables it flips. Here we show that estimating DEM event probabilities from experimental syndromes is feasible, avoids independent device benchmarking, and produces useful decoder priors for estimating and reducing decoded logical error probabilities. We evaluate our methods using open-source data from surface-code memory experiments performed on Google's Willow chip, and we carry out analogous surface-code experiments on IBM's \texttt{ibm\_miami} processor. Despite the different physical error scales of the Google and IBM devices, in both cases our estimated DEMs improve logical error probabilities relative to baseline device-informed DEMs, typically at the $5\%-10\%$ level and with larger gains in some IBM cases, without additional calibration circuits, decoder fine-tuning, or supervised fitting to logical outcomes.

21.
arXiv (CS.CV) 2026-06-12

UniDexTok: A Unified Dexterous Hand Tokenizer from Real Data

Dexterous hands are essential for fine-grained manipulation, but their hardware designs vary substantially across embodiments. Differences in kinematics, joint definitions, and degrees of freedom make it difficult to define a shared state representation compared with parallel grippers. As a result, dexterous-hand data remains fragmented and difficult to use for joint training. In this work, we propose the Unified Dexterous Hand Model (UDHM), which maps human and robot hand states into a shared 22-DoF semantic interface. Based on UDHM, we introduce UniDexTok, a retargeting-free state tokenizer that learns embodiment-conditioned discrete tokens from standardized real joint states. UniDexTok provides a unified representation for heterogeneous dexterous hands without relying on retargeting or simulation data. Compared with the recent baseline UniHM, UniDexTok reduces MPJAE from 15.63 degrees to 0.16 degrees and MPJPE from 18.51 mm to 0.18 mm, corresponding to error reductions of 98.98% and 99.03%, respectively. These results improve reconstruction from centimeter-scale to sub-millimeter accuracy. Experiments further show that data from other embodiments improves target-embodiment reconstruction accuracy, demonstrating the benefit of cross-embodiment tokenization. UniDexTok also shows strong zero-shot and few-shot reconstruction ability when new dexterous hands are introduced.

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

REACH: Interpretability-Driven Feature Identification and Architecture Compression for Multi-Channel Vehicular Channel Estimation

arXiv:2606.11857v1 Announce Type: cross Abstract: Multi-channel mixed-SNR training improves out-of-distribution (OOD) generalisation of deep learning channel estimators for IEEE 802.11p vehicular communications, yet the internal mechanism responsible for this remains unexplained. This work presents REACH (Relevance-based Explanation and Architectural Compression for cHannel estimators), a gradient-based interpretability framework that operates at two levels. Input-level attribution identifies a subset of time-frequency features consistently relevant across all evaluated channel conditions, enabling input dimensionality reduction with minimal performance loss. Filter-level attribution reveals a near-universal internal representation, providing a representational account of the observed OOD generalisation. Guided by the resulting filter taxonomy, relevance-guided architecture compression substantially reduces both the number of parameters and the number of floating-point operations (FLOPs) with sub-1 dB normalised mean square error (NMSE) degradation, and OOD generalisation degrades more slowly than within-distribution accuracy under increasing compression.

23.
arXiv (CS.CL) 2026-06-18

PreUnlearn: Auditing Collateral Knowledge Damage Before Large Language Model Unlearning

Machine unlearning for large language models (LLMs) aims to remove specified knowledge while preserving the rest of the model's capabilities. However, the boundary between knowledge to forget and knowledge to retain is often unclear, since related and even distant information may be entangled in the model. In this paper, we study LLM unlearning from a data-centric perspective and measure how unlearning effects propagate from the forget set to same-domain and distant-domain knowledge. We find a consistent decay pattern: collateral damage is strongest near the forget set, weakens with semantic distance, but does not disappear at domain boundaries. We further ask whether such damage can be audited before unlearning is executed. We formulate forget-set auditing as a pre-unlearning prediction task and analyze which data features are most predictive of downstream damage. Our results show that interaction features between the forget set and evaluation set provide the strongest signals, suggesting that collateral damage is partly reflected in data geometry before model updates occur. These findings position forget-set auditing as an early warning tool for identifying risky unlearning runs and designing more reliable unlearning procedures.

24.
arXiv (CS.AI) 2026-06-15

Can LLMs Accurately Score Medical Diagnoses and Clinical Reasoning?

arXiv:2604.14892v3 Announce Type: replace-cross Abstract: Evaluating medical AI systems using expert clinician panels is costly and slow, motivating the use of large language models (LLMs) as alternative adjudicators. Here, we evaluate an LLM Jury, composed of three frontier AI models, for scoring 3334 diagnoses on 300 real-world low- and middle-income country (LMIC) hospital cases. Both LLM- and clinician-generated diagnoses are scored against expert panel diagnoses across four dimensions: diagnosis, differential diagnosis, clinical reasoning, and negative treatment risk. The LLM Jury scores are compared with expert and independent re-scoring panel scores to assess error metrics, inter-rater agreement, severe-risk errors, and the effect of post hoc calibration using isotonic regression. In our data, we find that: (i) the uncalibrated LLM Jury scores preserve ordinal agreement with the expert clinician panel scores, but are systematically lower; (ii) the probability of severe-risk errors is lower for the LLM Jury than the human expert re-score panels; (iii) the LLM Jury combined with LLM diagnoses can be used to identify diagnoses at high risk of error, enabling targeted expert review and improved panel efficiency; (iv) the calibrated LLM Jury scores and rankings of diagnosing agents show excellent agreement with those of the primary expert panels; (v) LLM Jury models show no self-preference bias, they did not score diagnoses generated by their own underlying model or models from the same vendor more (or less) favourably than those generated by other models. Together, these results provide evidence that a calibrated LLM Jury is a trustworthy and reliable proxy for expert clinician evaluation in medical AI benchmarking. Confirming these findings in other clinical settings is an important direction for future work.

25.
medRxiv (Medicine) 2026-06-17

Performance of five risk stratification tools for paediatric pneumonia against WHO scores using data from the PediCAP trial in sub-Saharan Africa

Background Risk stratification tools for childhood pneumonia have been proposed to improve identification of children at highest risk of death, particularly in low-resource settings. However, their added value over the WHO Integrated Management of Childhood Illness (IMCI) criteria and danger signs remains uncertain. Methods We conducted a secondary analysis of a multi-country randomised controlled trial of children without HIV hospitalised with pneumonia in Mozambique, South Africa, Uganda, Zambia, and Zimbabwe. We evaluated the performance of five published risk scores alongside WHO IMCI severity classification and danger signs. Discrimination for (1) in-hospital mortality, (2) 28-day mortality, and (3) 28-day readmission or death was assessed using area under the receiver operating characteristic curve (AUC). Comparative performance and clinical utility were examined. Results Of the 1010 participants, 18 (1.8%) died in hospital, 22 (2.2%) died in hospital or in the 7 days post-discharge, and 63 (6.2%) died or were readmitted by day 28. Univariate case-fatality rates were highest for variables associated with malnutrition, convulsions, and hypoxaemia. All risk scores demonstrated moderate discrimination for in-hospital and in-hospital+7-day mortality (AUC range approximately 0.75-0.84), with no meaningful differences between models, and performed similarly to the WHO danger signs and IMCI severity classification. In contrast, all approaches performed poorly in predicting 28-day readmission or death (AUC approximately 0.54-0.58). No risk score consistently outperformed simple clinical criteria. Conclusions In this multi-country dataset, we found no evidence that published paediatric pneumonia risk scores meaningfully outperform WHO IMCI-based clinical assessment for predicting mortality. The relatively small number of mortality events limits precision, and modest differences cannot be excluded. These findings suggest that, in low-resource settings, strengthening implementation of existing WHO clinical criteria may be more effective than adopting more complex prediction tools.