Tao Tu

Karan Singhal, Shekoofeh Azizi, Tao Tu et al.

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

Tao Tu, Shekoofeh Azizi, Danny Driess et al.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Tao Tu, Shun-Po Chuang, Yu-Lun Liu et al. · nvidia

We propose ImGeoNet, a multi-view image-based 3D object detection framework that models a 3D space by an image-induced geometry-aware voxel representation. Unlike previous methods which aggregate 2D features into 3D voxels without considering geometry, ImGeoNet learns to induce geometry from multi-view images to alleviate the confusion arising from voxels of free space, and during the inference phase, only images from multiple views are required. Besides, a powerful pre-trained 2D feature extractor can be leveraged by our representation, leading to a more robust performance. To evaluate the effectiveness of ImGeoNet, we conduct quantitative and qualitative experiments on three indoor datasets, namely ARKitScenes, ScanNetV2, and ScanNet200. The results demonstrate that ImGeoNet outperforms the current state-of-the-art multi-view image-based method, ImVoxelNet, on all three datasets in terms of detection accuracy. In addition, ImGeoNet shows great data efficiency by achieving results comparable to ImVoxelNet with 100 views while utilizing only 40 views. Furthermore, our studies indicate that our proposed image-induced geometry-aware representation can enable image-based methods to attain superior detection accuracy than the seminal point cloud-based method, VoteNet, in two practical scenarios: (1) scenarios where point clouds are sparse and noisy, such as in ARKitScenes, and (2) scenarios involve diverse object classes, particularly classes of small objects, as in the case in ScanNet200.

Daniel McDuff, Mike Schaekermann, Tao Tu et al.

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

Ryutaro Tanno, David G. T. Barrett, Andrew Sellergren et al.

Radiology reports are an instrumental part of modern medicine, informing key clinical decisions such as diagnosis and treatment. The worldwide shortage of radiologists, however, restricts access to expert care and imposes heavy workloads, contributing to avoidable errors and delays in report delivery. While recent progress in automated report generation with vision-language models offer clear potential in ameliorating the situation, the path to real-world adoption has been stymied by the challenge of evaluating the clinical quality of AI-generated reports. In this study, we build a state-of-the-art report generation system for chest radiographs, $\textit{Flamingo-CXR}$, by fine-tuning a well-known vision-language foundation model on radiology data. To evaluate the quality of the AI-generated reports, a group of 16 certified radiologists provide detailed evaluations of AI-generated and human written reports for chest X-rays from an intensive care setting in the United States and an inpatient setting in India. At least one radiologist (out of two per case) preferred the AI report to the ground truth report in over 60$\%$ of cases for both datasets. Amongst the subset of AI-generated reports that contain errors, the most frequently cited reasons were related to the location and finding, whereas for human written reports, most mistakes were related to severity and finding. This disparity suggested potential complementarity between our AI system and human experts, prompting us to develop an assistive scenario in which Flamingo-CXR generates a first-draft report, which is subsequently revised by a clinician. This is the first demonstration of clinician-AI collaboration for report writing, and the resultant reports are assessed to be equivalent or preferred by at least one radiologist to reports written by experts alone in 80$\%$ of in-patient cases and 60$\%$ of intensive care cases.

Peter Brodeur, Jacob M. Koshy, Anil Palepu et al.

Large language model (LLM)-based AI systems have shown promise for patient-facing diagnostic and management conversations in simulated settings. Translating these systems into clinical practice requires assessment in real-world workflows with rigorous safety oversight. We report a prospective, single-arm feasibility study of an LLM-based conversational AI, the Articulate Medical Intelligence Explorer (AMIE), conducting clinical history taking and presentation of potential diagnoses for patients to discuss with their provider at urgent care appointments at a leading academic medical center. 100 adult patients completed an AMIE text-chat interaction up to 5 days before their appointment. We sought to assess the conversational safety and quality, patient and clinician experience, and clinical reasoning capabilities compared to primary care providers (PCPs). Human safety supervisors monitored all patient-AMIE interactions in real time and did not need to intervene to stop any consultations based on pre-defined criteria. Patients reported high satisfaction and their attitudes towards AI improved after interacting with AMIE (p < 0.001). PCPs found AMIE's output useful with a positive impact on preparedness. AMIE's differential diagnosis (DDx) included the final diagnosis, per chart review 8 weeks post-encounter, in 90% of cases, with 75% top-3 accuracy. Blinded assessment of AMIE and PCP DDx and management (Mx) plans suggested similar overall DDx and Mx plan quality, without significant differences for DDx (p = 0.6) and appropriateness and safety of Mx (p = 0.1 and 1.0, respectively). PCPs outperformed AMIE in the practicality (p = 0.003) and cost effectiveness (p = 0.004) of Mx. While further research is needed, this study demonstrates the initial feasibility, safety, and user acceptance of conversational AI in a real-world setting, representing crucial steps towards clinical translation.

Andrew Sellergren, Chufan Gao, Fereshteh Mahvar et al.

We introduce MedGemma 1.5 4B, the latest model in the MedGemma collection. MedGemma 1.5 expands on MedGemma 1 by integrating additional capabilities: high-dimensional medical imaging (CT/MRI volumes and histopathology whole slide images), anatomical localization via bounding boxes, multi-timepoint chest X-ray analysis, and improved medical document understanding (lab reports, electronic health records). We detail the innovations required to enable these modalities within a single architecture, including new training data, long-context 3D volume slicing, and whole-slide pathology sampling. Compared to MedGemma 1 4B, MedGemma 1.5 4B demonstrates significant gains in these new areas, improving 3D MRI condition classification accuracy by 11% and 3D CT condition classification by 3% (absolute improvements). In whole slide pathology imaging, MedGemma 1.5 4B achieves a 47% macro F1 gain. Additionally, it improves anatomical localization with a 35% increase in Intersection over Union on chest X-rays and achieves a 4% macro accuracy for longitudinal (multi-timepoint) chest x-ray analysis. Beyond its improved multimodal performance over MedGemma 1, MedGemma 1.5 improves on text-based clinical knowledge and reasoning, improving by 5% on MedQA accuracy and 22% on EHRQA accuracy. It also achieves an average of 18% macro F1 on 4 different lab report information extraction datasets (EHR Datasets 2, 3, 4, and Mendeley Clinical Laboratory Test Reports). Taken together, MedGemma 1.5 serves as a robust, open resource for the community, designed as an improved foundation on which developers can create the next generation of medical AI systems. Resources and tutorials for building upon MedGemma 1.5 can be found at https://goo.gle/MedGemma.

Xueqing Liu, Tao Tu, Paul Sajda

Simultaneous EEG-fMRI is a multi-modal neuroimaging technique that provides complementary spatial and temporal resolution. Challenging has been developing principled and interpretable approaches for fusing the modalities, specifically approaches enabling inference of latent source spaces representative of neural activity. In this paper, we address this inference problem within the framework of transcoding -- mapping from a specific encoding (modality) to a decoding (the latent source space) and then encoding the latent source space to the other modality. Specifically, we develop a symmetric method consisting of a cyclic convolutional transcoder that transcodes EEG to fMRI and vice versa. Without any prior knowledge of either the hemodynamic response function or lead field matrix, the complete data-driven method exploits the temporal and spatial relationships between the modalities and latent source spaces to learn these mappings. We quantify, for both the simulated and real EEG-fMRI data, how well the modalities can be transcoded from one to another as well as the source spaces that are recovered, all evaluated on unseen data. In addition to enabling a new way to symmetrically infer a latent source space, the method can also be seen as low-cost computational neuroimaging -- i.e. generating an 'expensive' fMRI BOLD image from 'low cost' EEG data.

Ting-Hsuan Chen, Ying-Huan Chen, Tao Tu et al.

Generating complete digital twins from videos requires precise camera control, global scene coverage, and strict spatial-temporal consistency constraints that remain challenging for perspective video generators due to their limited field of view (FoV). Their narrow FoV forces long or multi-view trajectories, amplifying cross-view inconsistency and temporal drift. We argue that 360° video generation offers a natural solution: panoramic coverage simplifies trajectory design and provides a strong global context for maintaining coherence. We introduce Pantheon360: Taming Digital Twin Generation via 3D-Aware 360° Video Diffusion, a controllable 360° video generation framework that synthesizes high-fidelity videos from sparse 360° inputs. The key idea is an explicit 3D Cache, reconstructed from the input, which serves as a geometric scaffold for any user-defined camera path. This allows the diffusion model to focus on photorealistic texture refinement while the 3D Cache enforces global geometric consistency. Experiments show that Pantheon360 achieves superior visual quality and unmatched geometric coherence, enabling reliable and flexible 360° scene generation for downstream simulation and digital-twin applications.

Zhixiang Wei, Lin Chen, Tao Tu et al.

Most prior semantic segmentation methods have been developed for day-time scenes, while typically underperforming in night-time scenes due to insufficient and complicated lighting conditions. In this work, we tackle this challenge by proposing a novel night-time semantic segmentation paradigm, i.e., disentangle then parse (DTP). DTP explicitly disentangles night-time images into light-invariant reflectance and light-specific illumination components and then recognizes semantics based on their adaptive fusion. Concretely, the proposed DTP comprises two key components: 1) Instead of processing lighting-entangled features as in prior works, our Semantic-Oriented Disentanglement (SOD) framework enables the extraction of reflectance component without being impeded by lighting, allowing the network to consistently recognize the semantics under cover of varying and complicated lighting conditions. 2) Based on the observation that the illumination component can serve as a cue for some semantically confused regions, we further introduce an Illumination-Aware Parser (IAParser) to explicitly learn the correlation between semantics and lighting, and aggregate the illumination features to yield more precise predictions. Extensive experiments on the night-time segmentation task with various settings demonstrate that DTP significantly outperforms state-of-the-art methods. Furthermore, with negligible additional parameters, DTP can be directly used to benefit existing day-time methods for night-time segmentation.

Gheorghe Comanici, Eric Bieber, Mike Schaekermann et al. · amazon-science, baidu

In this report, we introduce the Gemini 2.X model family: Gemini 2.5 Pro and Gemini 2.5 Flash, as well as our earlier Gemini 2.0 Flash and Flash-Lite models. Gemini 2.5 Pro is our most capable model yet, achieving SoTA performance on frontier coding and reasoning benchmarks. In addition to its incredible coding and reasoning skills, Gemini 2.5 Pro is a thinking model that excels at multimodal understanding and it is now able to process up to 3 hours of video content. Its unique combination of long context, multimodal and reasoning capabilities can be combined to unlock new agentic workflows. Gemini 2.5 Flash provides excellent reasoning abilities at a fraction of the compute and latency requirements and Gemini 2.0 Flash and Flash-Lite provide high performance at low latency and cost. Taken together, the Gemini 2.X model generation spans the full Pareto frontier of model capability vs cost, allowing users to explore the boundaries of what is possible with complex agentic problem solving.

Khaled Saab, Tao Tu, Wei-Hung Weng et al.

Excellence in a wide variety of medical applications poses considerable challenges for AI, requiring advanced reasoning, access to up-to-date medical knowledge and understanding of complex multimodal data. Gemini models, with strong general capabilities in multimodal and long-context reasoning, offer exciting possibilities in medicine. Building on these core strengths of Gemini, we introduce Med-Gemini, a family of highly capable multimodal models that are specialized in medicine with the ability to seamlessly use web search, and that can be efficiently tailored to novel modalities using custom encoders. We evaluate Med-Gemini on 14 medical benchmarks, establishing new state-of-the-art (SoTA) performance on 10 of them, and surpass the GPT-4 model family on every benchmark where a direct comparison is viable, often by a wide margin. On the popular MedQA (USMLE) benchmark, our best-performing Med-Gemini model achieves SoTA performance of 91.1% accuracy, using a novel uncertainty-guided search strategy. On 7 multimodal benchmarks including NEJM Image Challenges and MMMU (health & medicine), Med-Gemini improves over GPT-4V by an average relative margin of 44.5%. We demonstrate the effectiveness of Med-Gemini's long-context capabilities through SoTA performance on a needle-in-a-haystack retrieval task from long de-identified health records and medical video question answering, surpassing prior bespoke methods using only in-context learning. Finally, Med-Gemini's performance suggests real-world utility by surpassing human experts on tasks such as medical text summarization, alongside demonstrations of promising potential for multimodal medical dialogue, medical research and education. Taken together, our results offer compelling evidence for Med-Gemini's potential, although further rigorous evaluation will be crucial before real-world deployment in this safety-critical domain.

Juraj Gottweis, Wei-Hung Weng, Alexander Daryin et al.

Scientific discovery relies on scientists generating novel hypotheses that undergo rigorous experimental validation. To augment this process, we introduce an AI co-scientist, a multi-agent system built on Gemini 2.0. The AI co-scientist is intended to help uncover new, original knowledge and to formulate demonstrably novel research hypotheses and proposals, building upon prior evidence and aligned to scientist-provided research objectives and guidance. The system's design incorporates a generate, debate, and evolve approach to hypothesis generation, inspired by the scientific method and accelerated by scaling test-time compute. Key contributions include: (1) a multi-agent architecture with an asynchronous task execution framework for flexible compute scaling; (2) a tournament evolution process for self-improving hypotheses generation. Automated evaluations show continued benefits of test-time compute, improving hypothesis quality. While general purpose, we focus development and validation in three biomedical areas: drug repurposing, novel target discovery, and explaining mechanisms of bacterial evolution and anti-microbial resistance. For drug repurposing, the system proposes candidates with promising validation findings, including candidates for acute myeloid leukemia that show tumor inhibition in vitro at clinically applicable concentrations. For novel target discovery, the AI co-scientist proposed new epigenetic targets for liver fibrosis, validated by anti-fibrotic activity and liver cell regeneration in human hepatic organoids. Finally, the AI co-scientist recapitulated unpublished experimental results via a parallel in silico discovery of a novel gene transfer mechanism in bacterial evolution. These results, detailed in separate, co-timed reports, demonstrate the potential to augment biomedical and scientific discovery and usher an era of AI empowered scientists.

Tao Tu, Anil Palepu, Mike Schaekermann et al.

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Zhixiang Wei, Xiaoxiao Ma, Ruishen Yan et al.

Vision Foundation Models(VFMs) have achieved remarkable success in various computer vision tasks. However, their application to semantic segmentation is hindered by two significant challenges: (1) the disparity in data scale, as segmentation datasets are typically much smaller than those used for VFM pre-training, and (2) domain distribution shifts, where real-world segmentation scenarios are diverse and often underrepresented during pre-training. To overcome these limitations, we present Rein++, an efficient VFM-based segmentation framework that demonstrates superior generalization from limited data and enables effective adaptation to diverse unlabeled scenarios. Specifically, Rein++ comprises a domain generalization solution Rein-G and a domain adaptation solution Rein-A. Rein-G introduces a set of trainable, instance-aware tokens that effectively refine the VFM's features for the segmentation task. This parameter-efficient approach fine-tunes less than 1% of the backbone's parameters, enabling robust generalization. Building on the Rein-G, Rein-A performs unsupervised domain adaptation at both the instance and logit levels to mitigate domain shifts. In addition, it incorporates a semantic transfer module that leverages the class-agnostic capabilities of the segment anything model to enhance boundary details in the target domain. The integrated Rein++ pipeline first learns a generalizable model on a source domain (e.g., daytime scenes) and subsequently adapts it to diverse target domains (e.g., nighttime scenes) without any target labels. Comprehensive experiments demonstrate that Rein++ significantly outperforms state-of-the-art methods with efficient training, underscoring its roles an efficient, generalizable, and adaptive segmentation solution for VFMs, even for large models with billions of parameters. The code is available at https://github.com/wloves/Rein.

Tao Tu, Ming-Feng Li, Chieh Hubert Lin et al.

Articulated 3D reconstruction has valuable applications in various domains, yet it remains costly and demands intensive work from domain experts. Recent advancements in template-free learning methods show promising results with monocular videos. Nevertheless, these approaches necessitate a comprehensive coverage of all viewpoints of the subject in the input video, thus limiting their applicability to casually captured videos from online sources. In this work, we study articulated 3D shape reconstruction from a single and casually captured internet video, where the subject's view coverage is incomplete. We propose DreaMo that jointly performs shape reconstruction while solving the challenging low-coverage regions with view-conditioned diffusion prior and several tailored regularizations. In addition, we introduce a skeleton generation strategy to create human-interpretable skeletons from the learned neural bones and skinning weights. We conduct our study on a self-collected internet video collection characterized by incomplete view coverage. DreaMo shows promising quality in novel-view rendering, detailed articulated shape reconstruction, and skeleton generation. Extensive qualitative and quantitative studies validate the efficacy of each proposed component, and show existing methods are unable to solve correct geometry due to the incomplete view coverage.

Yen-Siang Wu, Rundong Luo, Jingsen Zhu et al.

How can we tell whether a video has been sped up or slowed down? How can we generate videos at different speeds? Although videos have been central to modern computer vision research, little attention has been paid to perceiving and controlling the passage of time. In this paper, we study time as a learnable visual concept and develop models for reasoning about and manipulating the flow of time in videos. We first exploit the multimodal cues and temporal structure naturally present in videos to learn, in a self-supervised manner, to detect speed changes and estimate playback speed. We then show that these learned temporal reasoning models enable us to curate the largest slow-motion video dataset to date from noisy in-the-wild sources. Such slow-motion footage, typically filmed by high-speed cameras, contains substantially richer temporal detail than standard videos. Using this data, we further develop models capable of temporal control, including speed-conditioned video generation, which produces motion at specified playback speed, and temporal super-resolution, which tranforms low-FPS, blurry videos into high-FPS sequences with fine-grained temporal details. Our findings highlight time as a manipulable, perceptual dimension in video learning, opening doors to temporally controllable video generation, temporal forensics detection, and potentially richer world-models that understand how events unfold over time.

Khaled Saab, Jan Freyberg, Chunjong Park et al.

Large Language Models (LLMs) have demonstrated great potential for conducting diagnostic conversations but evaluation has been largely limited to language-only interactions, deviating from the real-world requirements of remote care delivery. Instant messaging platforms permit clinicians and patients to upload and discuss multimodal medical artifacts seamlessly in medical consultation, but the ability of LLMs to reason over such data while preserving other attributes of competent diagnostic conversation remains unknown. Here we advance the conversational diagnosis and management performance of the Articulate Medical Intelligence Explorer (AMIE) through a new capability to gather and interpret multimodal data, and reason about this precisely during consultations. Leveraging Gemini 2.0 Flash, our system implements a state-aware dialogue framework, where conversation flow is dynamically controlled by intermediate model outputs reflecting patient states and evolving diagnoses. Follow-up questions are strategically directed by uncertainty in such patient states, leading to a more structured multimodal history-taking process that emulates experienced clinicians. We compared AMIE to primary care physicians (PCPs) in a randomized, blinded, OSCE-style study of chat-based consultations with patient actors. We constructed 105 evaluation scenarios using artifacts like smartphone skin photos, ECGs, and PDFs of clinical documents across diverse conditions and demographics. Our rubric assessed multimodal capabilities and other clinically meaningful axes like history-taking, diagnostic accuracy, management reasoning, communication, and empathy. Specialist evaluation showed AMIE to be superior to PCPs on 7/9 multimodal and 29/32 non-multimodal axes (including diagnostic accuracy). The results show clear progress in multimodal conversational diagnostic AI, but real-world translation needs further research.

Anil Palepu, Valentin Liévin, Wei-Hung Weng et al.

While large language models (LLMs) have shown promise in diagnostic dialogue, their capabilities for effective management reasoning - including disease progression, therapeutic response, and safe medication prescription - remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE) through a new LLM-based agentic system optimised for clinical management and dialogue, incorporating reasoning over the evolution of disease and multiple patient visit encounters, response to therapy, and professional competence in medication prescription. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini's long-context capabilities, combining in-context retrieval with structured reasoning to align its output with relevant and up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialist physicians and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding of management plans in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. While AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE's strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

Anil Palepu, Vikram Dhillon, Polly Niravath et al.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Jin-Cheng Jhang, Tao Tu, Fu-En Wang et al.

The field of indoor monocular 3D object detection is gaining significant attention, fueled by the increasing demand in VR/AR and robotic applications. However, its advancement is impeded by the limited availability and diversity of 3D training data, owing to the labor-intensive nature of 3D data collection and annotation processes. In this paper, we present V-MIND (Versatile Monocular INdoor Detector), which enhances the performance of indoor 3D detectors across a diverse set of object classes by harnessing publicly available large-scale 2D datasets. By leveraging well-established monocular depth estimation techniques and camera intrinsic predictors, we can generate 3D training data by converting large-scale 2D images into 3D point clouds and subsequently deriving pseudo 3D bounding boxes. To mitigate distance errors inherent in the converted point clouds, we introduce a novel 3D self-calibration loss for refining the pseudo 3D bounding boxes during training. Additionally, we propose a novel ambiguity loss to address the ambiguity that arises when introducing new classes from 2D datasets. Finally, through joint training with existing 3D datasets and pseudo 3D bounding boxes derived from 2D datasets, V-MIND achieves state-of-the-art object detection performance across a wide range of classes on the Omni3D indoor dataset.

Peng-Hao Hsu, Ke Zhang, Fu-En Wang et al.

Open-vocabulary (OV) 3D object detection is an emerging field, yet its exploration through image-based methods remains limited compared to 3D point cloud-based methods. We introduce OpenM3D, a novel open-vocabulary multi-view indoor 3D object detector trained without human annotations. In particular, OpenM3D is a single-stage detector adapting the 2D-induced voxel features from the ImGeoNet model. To support OV, it is jointly trained with a class-agnostic 3D localization loss requiring high-quality 3D pseudo boxes and a voxel-semantic alignment loss requiring diverse pre-trained CLIP features. We follow the training setting of OV-3DET where posed RGB-D images are given but no human annotations of 3D boxes or classes are available. We propose a 3D Pseudo Box Generation method using a graph embedding technique that combines 2D segments into coherent 3D structures. Our pseudo-boxes achieve higher precision and recall than other methods, including the method proposed in OV-3DET. We further sample diverse CLIP features from 2D segments associated with each coherent 3D structure to align with the corresponding voxel feature. The key to training a highly accurate single-stage detector requires both losses to be learned toward high-quality targets. At inference, OpenM3D, a highly efficient detector, requires only multi-view images for input and demonstrates superior accuracy and speed (0.3 sec. per scene) on ScanNet200 and ARKitScenes indoor benchmarks compared to existing methods. We outperform a strong two-stage method that leverages our class-agnostic detector with a ViT CLIP-based OV classifier and a baseline incorporating multi-view depth estimator on both accuracy and speed.

Elahe Vedadi, David Barrett, Natalie Harris et al.

Recent work has demonstrated the promise of conversational AI systems for diagnostic dialogue. However, real-world assurance of patient safety means that providing individual diagnoses and treatment plans is considered a regulated activity by licensed professionals. Furthermore, physicians commonly oversee other team members in such activities, including nurse practitioners (NPs) or physician assistants/associates (PAs). Inspired by this, we propose a framework for effective, asynchronous oversight of the Articulate Medical Intelligence Explorer (AMIE) AI system. We propose guardrailed-AMIE (g-AMIE), a multi-agent system that performs history taking within guardrails, abstaining from individualized medical advice. Afterwards, g-AMIE conveys assessments to an overseeing primary care physician (PCP) in a clinician cockpit interface. The PCP provides oversight and retains accountability of the clinical decision. This effectively decouples oversight from intake and can thus happen asynchronously. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) of text consultations with asynchronous oversight, we compared g-AMIE to NPs/PAs or a group of PCPs under the same guardrails. Across 60 scenarios, g-AMIE outperformed both groups in performing high-quality intake, summarizing cases, and proposing diagnoses and management plans for the overseeing PCP to review. This resulted in higher quality composite decisions. PCP oversight of g-AMIE was also more time-efficient than standalone PCP consultations in prior work. While our study does not replicate existing clinical practices and likely underestimates clinicians' capabilities, our results demonstrate the promise of asynchronous oversight as a feasible paradigm for diagnostic AI systems to operate under expert human oversight for enhancing real-world care.

Juan Manuel Zambrano Chaves, Eric Wang, Tao Tu et al.

Developing therapeutics is a lengthy and expensive process that requires the satisfaction of many different criteria, and AI models capable of expediting the process would be invaluable. However, the majority of current AI approaches address only a narrowly defined set of tasks, often circumscribed within a particular domain. To bridge this gap, we introduce Tx-LLM, a generalist large language model (LLM) fine-tuned from PaLM-2 which encodes knowledge about diverse therapeutic modalities. Tx-LLM is trained using a collection of 709 datasets that target 66 tasks spanning various stages of the drug discovery pipeline. Using a single set of weights, Tx-LLM simultaneously processes a wide variety of chemical or biological entities(small molecules, proteins, nucleic acids, cell lines, diseases) interleaved with free-text, allowing it to predict a broad range of associated properties, achieving competitive with state-of-the-art (SOTA) performance on 43 out of 66 tasks and exceeding SOTA on 22. Among these, Tx-LLM is particularly powerful and exceeds best-in-class performance on average for tasks combining molecular SMILES representations with text such as cell line names or disease names, likely due to context learned during pretraining. We observe evidence of positive transfer between tasks with diverse drug types (e.g.,tasks involving small molecules and tasks involving proteins), and we study the impact of model size, domain finetuning, and prompting strategies on performance. We believe Tx-LLM represents an important step towards LLMs encoding biochemical knowledge and could have a future role as an end-to-end tool across the drug discovery development pipeline.

Lin Yang, Shawn Xu, Andrew Sellergren et al.

Many clinical tasks require an understanding of specialized data, such as medical images and genomics, which is not typically found in general-purpose large multimodal models. Building upon Gemini's multimodal models, we develop several models within the new Med-Gemini family that inherit core capabilities of Gemini and are optimized for medical use via fine-tuning with 2D and 3D radiology, histopathology, ophthalmology, dermatology and genomic data. Med-Gemini-2D sets a new standard for AI-based chest X-ray (CXR) report generation based on expert evaluation, exceeding previous best results across two separate datasets by an absolute margin of 1% and 12%, where 57% and 96% of AI reports on normal cases, and 43% and 65% on abnormal cases, are evaluated as "equivalent or better" than the original radiologists' reports. We demonstrate the first ever large multimodal model-based report generation for 3D computed tomography (CT) volumes using Med-Gemini-3D, with 53% of AI reports considered clinically acceptable, although additional research is needed to meet expert radiologist reporting quality. Beyond report generation, Med-Gemini-2D surpasses the previous best performance in CXR visual question answering (VQA) and performs well in CXR classification and radiology VQA, exceeding SoTA or baselines on 17 of 20 tasks. In histopathology, ophthalmology, and dermatology image classification, Med-Gemini-2D surpasses baselines across 18 out of 20 tasks and approaches task-specific model performance. Beyond imaging, Med-Gemini-Polygenic outperforms the standard linear polygenic risk score-based approach for disease risk prediction and generalizes to genetically correlated diseases for which it has never been trained. Although further development and evaluation are necessary in the safety-critical medical domain, our results highlight the potential of Med-Gemini across a wide range of medical tasks.

Karan Singhal, Tao Tu, Juraj Gottweis et al.

Recent artificial intelligence (AI) systems have reached milestones in "grand challenges" ranging from Go to protein-folding. The capability to retrieve medical knowledge, reason over it, and answer medical questions comparably to physicians has long been viewed as one such grand challenge. Large language models (LLMs) have catalyzed significant progress in medical question answering; Med-PaLM was the first model to exceed a "passing" score in US Medical Licensing Examination (USMLE) style questions with a score of 67.2% on the MedQA dataset. However, this and other prior work suggested significant room for improvement, especially when models' answers were compared to clinicians' answers. Here we present Med-PaLM 2, which bridges these gaps by leveraging a combination of base LLM improvements (PaLM 2), medical domain finetuning, and prompting strategies including a novel ensemble refinement approach. Med-PaLM 2 scored up to 86.5% on the MedQA dataset, improving upon Med-PaLM by over 19% and setting a new state-of-the-art. We also observed performance approaching or exceeding state-of-the-art across MedMCQA, PubMedQA, and MMLU clinical topics datasets. We performed detailed human evaluations on long-form questions along multiple axes relevant to clinical applications. In pairwise comparative ranking of 1066 consumer medical questions, physicians preferred Med-PaLM 2 answers to those produced by physicians on eight of nine axes pertaining to clinical utility (p < 0.001). We also observed significant improvements compared to Med-PaLM on every evaluation axis (p < 0.001) on newly introduced datasets of 240 long-form "adversarial" questions to probe LLM limitations. While further studies are necessary to validate the efficacy of these models in real-world settings, these results highlight rapid progress towards physician-level performance in medical question answering.

Tao Tu, Qing Ping, Govind Thattai et al.

GuessWhat?! is a two-player visual dialog guessing game where player A asks a sequence of yes/no questions (Questioner) and makes a final guess (Guesser) about a target object in an image, based on answers from player B (Oracle). Based on this dialog history between the Questioner and the Oracle, a Guesser makes a final guess of the target object. Previous baseline Oracle model encodes no visual information in the model, and it cannot fully understand complex questions about color, shape, relationships and so on. Most existing work for Guesser encode the dialog history as a whole and train the Guesser models from scratch on the GuessWhat?! dataset. This is problematic since language encoder tend to forget long-term history and the GuessWhat?! data is sparse in terms of learning visual grounding of objects. Previous work for Questioner introduces state tracking mechanism into the model, but it is learned as a soft intermediates without any prior vision-linguistic insights. To bridge these gaps, in this paper we propose Vilbert-based Oracle, Guesser and Questioner, which are all built on top of pretrained vision-linguistic model, Vilbert. We introduce two-way background/target fusion mechanism into Vilbert-Oracle to account for both intra and inter-object questions. We propose a unified framework for Vilbert-Guesser and Vilbert-Questioner, where state-estimator is introduced to best utilize Vilbert's power on single-turn referring expression comprehension. Experimental results show that our proposed models outperform state-of-the-art models significantly by 7%, 10%, 12% for Oracle, Guesser and End-to-End Questioner respectively.

Tao Tu, Yuan-Jui Chen, Alexander H. Liu et al.

Recently, end-to-end multi-speaker text-to-speech (TTS) systems gain success in the situation where a lot of high-quality speech plus their corresponding transcriptions are available. However, laborious paired data collection processes prevent many institutes from building multi-speaker TTS systems of great performance. In this work, we propose a semi-supervised learning approach for multi-speaker TTS. A multi-speaker TTS model can learn from the untranscribed audio via the proposed encoder-decoder framework with discrete speech representation. The experiment results demonstrate that with only an hour of paired speech data, no matter the paired data is from multiple speakers or a single speaker, the proposed model can generate intelligible speech in different voices. We found the model can benefit from the proposed semi-supervised learning approach even when part of the unpaired speech data is noisy. In addition, our analysis reveals that different speaker characteristics of the paired data have an impact on the effectiveness of semi-supervised TTS.

Alexander H. Liu, Tao Tu, Hung-yi Lee et al.

In this paper we propose a Sequential Representation Quantization AutoEncoder (SeqRQ-AE) to learn from primarily unpaired audio data and produce sequences of representations very close to phoneme sequences of speech utterances. This is achieved by proper temporal segmentation to make the representations phoneme-synchronized, and proper phonetic clustering to have total number of distinct representations close to the number of phonemes. Mapping between the distinct representations and phonemes is learned from a small amount of annotated paired data. Preliminary experiments on LJSpeech demonstrated the learned representations for vowels have relative locations in latent space in good parallel to that shown in the IPA vowel chart defined by linguistics experts. With less than 20 minutes of annotated speech, our method outperformed existing methods on phoneme recognition and is able to synthesize intelligible speech that beats our baseline model.

Tao Tu, Yuan-Jui Chen, Cheng-chieh Yeh et al.

End-to-end text-to-speech (TTS) has shown great success on large quantities of paired text plus speech data. However, laborious data collection remains difficult for at least 95% of the languages over the world, which hinders the development of TTS in different languages. In this paper, we aim to build TTS systems for such low-resource (target) languages where only very limited paired data are available. We show such TTS can be effectively constructed by transferring knowledge from a high-resource (source) language. Since the model trained on source language cannot be directly applied to target language due to input space mismatch, we propose a method to learn a mapping between source and target linguistic symbols. Benefiting from this learned mapping, pronunciation information can be preserved throughout the transferring procedure. Preliminary experiments show that we only need around 15 minutes of paired data to obtain a relatively good TTS system. Furthermore, analytic studies demonstrated that the automatically discovered mapping correlate well with the phonetic expertise.