Junmin Huang

Ziqian Bi, Lu Chen, Junhao Song et al.

This study presents the first comprehensive evaluation of thinking budget mechanisms in medical reasoning tasks, revealing fundamental scaling laws between computational resources and reasoning quality. We systematically evaluated two major model families, Qwen3 (1.7B to 235B parameters) and DeepSeek-R1 (1.5B to 70B parameters), across 15 medical datasets spanning diverse specialties and difficulty levels. Through controlled experiments with thinking budgets ranging from zero to unlimited tokens, we establish logarithmic scaling relationships where accuracy improvements follow a predictable pattern with both thinking budget and model size. Our findings identify three distinct efficiency regimes: high-efficiency (0 to 256 tokens) suitable for real-time applications, balanced (256 to 512 tokens) offering optimal cost-performance tradeoffs for routine clinical support, and high-accuracy (above 512 tokens) justified only for critical diagnostic tasks. Notably, smaller models demonstrate disproportionately larger benefits from extended thinking, with 15 to 20% improvements compared to 5 to 10% for larger models, suggesting a complementary relationship where thinking budget provides greater relative benefits for capacity-constrained models. Domain-specific patterns emerge clearly, with neurology and gastroenterology requiring significantly deeper reasoning processes than cardiovascular or respiratory medicine. The consistency between Qwen3 native thinking budget API and our proposed truncation method for DeepSeek-R1 validates the generalizability of thinking budget concepts across architectures. These results establish thinking budget control as a critical mechanism for optimizing medical AI systems, enabling dynamic resource allocation aligned with clinical needs while maintaining the transparency essential for healthcare deployment.

Han Wang, Ruoyun He, Guoguang Lao et al.

Early identification of high-risk ICU patients is crucial for directing limited medical resources. We introduce ALFIA (Adaptive Layer Fusion with Intelligent Attention), a modular, attention-based architecture that jointly trains LoRA (Low-Rank Adaptation) adapters and an adaptive layer-weighting mechanism to fuse multi-layer semantic features from a BERT backbone. Trained on our rigorous cw-24 (CriticalWindow-24) benchmark, ALFIA surpasses state-of-the-art tabular classifiers in AUPRC while preserving a balanced precision-recall profile. The embeddings produced by ALFIA's fusion module, capturing both fine-grained clinical cues and high-level concepts, enable seamless pairing with GBDTs (CatBoost/LightGBM) as ALFIA-boost, and deep neuro networks as ALFIA-nn, yielding additional performance gains. Our experiments confirm ALFIA's superior early-warning performance, by operating directly on routine clinical text, it furnishes clinicians with a convenient yet robust tool for risk stratification and timely intervention in critical-care settings.

Baozhu Huang, Cheng Chen, Xuanhe Hou et al.

The intensive care unit (ICU) manages critically ill patients, many of whom face a high risk of mortality. Early and accurate prediction of in-hospital mortality within the first 24 hours of ICU admission is crucial for timely clinical interventions, resource optimization, and improved patient outcomes. Traditional scoring systems, while useful, often have limitations in predictive accuracy and adaptability. Objective: This review aims to systematically evaluate and benchmark innovative methodologies that leverage data available within the first day of ICU admission for predicting in-hospital mortality. We focus on advancements in machine learning, novel biomarker applications, and the integration of diverse data types.