Minmin Zhang

Minmin Zhang, Sina Aghaei, Soroush Saghafian

Large language models (LLMs) have shown remarkable in-context learning (ICL) capabilities, yet their potential for sequential decision-making remains underexplored. In this paper, we study the ICL capabilities of LLMs in sequential decision-making settings, including Markov Decision Processes (MDPs), Partially Observable MDPs (POMDPs), and Ambiguous POMDPs (APOMDPs). We fine-tune pretrained LLMs to perform few-shot decision-making directly from offline, oracle-labeled trajectories. Our framework enables flexible imitation of policies through supervised fine-tuning (SFT). Theoretically, we focus on linear MDPs and interpret a fine-tuned attention layer as implicitly estimating optimal Q-functions from in-context data. Building on this interpretation, we derive an end-to-end suboptimality bound for the induced policy that separates the in-context estimation error from the training-length bias. Empirically, across synthetic MDP, POMDP, and APOMDP settings, we find that fine-tuned LLMs achieve substantially smaller optimality gaps than in-context-only and random baselines, with especially large gains in longer-horizon, partially observed, and model-ambiguous environments. Together, these results show that supervised fine-tuning provides an effective route to endowing pretrained LLMs with sequential decision-making capabilities from offline data, which is an important advantage in domains such as healthcare where offline data are abundant.

Yikun Ma, Bo Li, Ying Chen et al.

The early detection of esophagogastric junction adenocarcinoma (EGJA) is crucial for improving patient prognosis, yet its current diagnosis is highly operator-dependent. This paper aims to make the first attempt to develop an artificial intelligence (AI) foundation model-based method for both screening and staging diagnosis of EGJA using endoscopic images. In this cohort and learning study, we conducted a multicentre study across seven Chinese hospitals between December 28, 2016 and December 30, 2024. It comprises 12,302 images from 1,546 patients; 8,249 of them were employed for model training, while the remaining were divided into the held-out (112 patients, 914 images), external (230 patients, 1,539 images), and prospective (198 patients, 1,600 images) test sets for evaluation. The proposed model employs DINOv2 (a vision foundation model) and ResNet50 (a convolutional neural network) to extract features of global appearance and local details of endoscopic images for EGJA staging diagnosis. Our model demonstrates satisfactory performance for EGJA staging diagnosis across three test sets, achieving an accuracy of 0.9256, 0.8895, and 0.8956, respectively. In contrast, among representative AI models, the best one (ResNet50) achieves an accuracy of 0.9125, 0.8382, and 0.8519 on the three test sets, respectively; the expert endoscopists achieve an accuracy of 0.8147 on the held-out test set. Moreover, with the assistance of our model, the overall accuracy for the trainee, competent, and expert endoscopists improves from 0.7035, 0.7350, and 0.8147 to 0.8497, 0.8521, and 0.8696, respectively. To our knowledge, our model is the first application of foundation models for EGJA staging diagnosis and demonstrates great potential in both diagnostic accuracy and efficiency.