Fangyuan Chen

Qiao Jin, Zifeng Wang, Charalampos S. Floudas et al. · tsinghua

Patient recruitment is challenging for clinical trials. We introduce TrialGPT, an end-to-end framework for zero-shot patient-to-trial matching with large language models. TrialGPT comprises three modules: it first performs large-scale filtering to retrieve candidate trials (TrialGPT-Retrieval); then predicts criterion-level patient eligibility (TrialGPT-Matching); and finally generates trial-level scores (TrialGPT-Ranking). We evaluate TrialGPT on three cohorts of 183 synthetic patients with over 75,000 trial annotations. TrialGPT-Retrieval can recall over 90% of relevant trials using less than 6% of the initial collection. Manual evaluations on 1,015 patient-criterion pairs show that TrialGPT-Matching achieves an accuracy of 87.3% with faithful explanations, close to the expert performance. The TrialGPT-Ranking scores are highly correlated with human judgments and outperform the best-competing models by 43.8% in ranking and excluding trials. Furthermore, our user study reveals that TrialGPT can reduce the screening time by 42.6% in patient recruitment. Overall, these results have demonstrated promising opportunities for patient-to-trial matching with TrialGPT.

Zihan Guan, Qiao Jin, Guangzhi Xiong et al.

The existing methods for evaluating the medical knowledge of Large Language Models (LLMs) are largely based on atemporal examination-style benchmarks, while in reality, medical knowledge is inherently dynamic and continuously evolves as new evidence emerges and treatments are approved. Consequently, evaluating medical knowledge without a temporal context may provide an incomplete assessment of whether LLMs can accurately reason about time-specific medical knowledge. Moreover, most medical data are historical, requiring the models not only to recall the correct knowledge, but also to know when that knowledge is correct. To bridge the gap, we built TempoMed-Bench, the first-of-its-kind benchmark for evaluating the temporal awareness of the LLMs in the medical domain through evolving guideline knowledge. Based on the TempoMed-Bench, our evaluation analysis first reveals that LLMs lack temporal awareness in medical knowledge through the key findings: (1) model performance on up-to-date medical knowledge exhibits a gradual linear decline over time rather than a sharp knowledge-cutoff behavior, suggesting that parametric medical knowledge is not strictly bounded by knowledge cutoffs; (2) LLMs consistently struggle more with recalling outdated historical medical knowledge than with up-to-date recommendations: accuracy of historical knowledge is only 25.37%-53.89% of up-to-date knowledge, indicating potential knowledge forgetting effects during training; and (3) LLMs often exhibit temporally inconsistent behaviors, where predictions fluctuate irregularly across neighboring years. We also show that the temporal awareness problem is a challenge that cannot be easily solved when integrated with agentic search tools (-3.15%-14.14%). This work highlights an important yet underexplored challenge and motivates future research on developing LLMs that can better encode time-specific medical knowledge.

Ao Xu, Rujin Zhao, Xiong Xu et al.

Existing stereo matching networks typically rely on either cost-volume construction based on 3D convolutions or deformation methods based on iterative optimization. The former incurs significant computational overhead during cost aggregation, whereas the latter often lacks the ability to model non-local contextual information. These methods exhibit poor compatibility on resource-constrained mobile devices, limiting their deployment in real-time applications. To address this, we propose a Multi-frequency Adaptive Fusion Network (MAFNet), which can produce high-quality disparity maps using only efficient 2D convolutions. Specifically, we design an adaptive frequency-domain filtering attention module that decomposes the full cost volume into high-frequency and low-frequency volumes, performing frequency-aware feature aggregation separately. Subsequently, we introduce a Linformer-based low-rank attention mechanism to adaptively fuse high- and low-frequency information, yielding more robust disparity estimation. Extensive experiments demonstrate that the proposed MAFNet significantly outperforms existing real-time methods on public datasets such as Scene Flow and KITTI 2015, showing a favorable balance between accuracy and real-time performance.

Guangzhi Xiong, Qiao Jin, Xiao Wang et al.

Retrieval-augmented generation (RAG) has shown great promise for knowledge-intensive tasks and recently advanced with agentic RAG, where language agents engage in multi-round interactions with external knowledge sources for adaptive information retrieval. However, existing agentic RAG methods often depend on ad-hoc prompt engineering and lack a unified optimization framework. We introduce RAG-Gym, a comprehensive platform that systematically explores three optimization dimensions: (1) prompt engineering, (2) actor tuning, and (3) critic training. For prompt engineering, we propose Re$^2$Search, a novel agent incorporating reasoning reflection that significantly outperforms standard prompts. In actor tuning, we evaluate three popular post-training algorithms with fine-grained process supervision and identify direct preference optimization as the most effective. We further demonstrate that a trained critic can enhance inference by selecting higher-quality intermediate reasoning steps. Together, these findings lead to the optimized Re$^2$Search++ agent, which surpasses most recent methods like Search-R1 by a relative increase of 3.2% to 11.6% in average F1. Finally, we examine the impact of different reward sources and analyze scaling properties in training and inference, offering practical insights for agentic RAG optimization. The project homepage is available at https://rag-gym.github.io.

Qiao Jin, Fangyuan Chen, Yiliang Zhou et al.

Recent studies indicate that Generative Pre-trained Transformer 4 with Vision (GPT-4V) outperforms human physicians in medical challenge tasks. However, these evaluations primarily focused on the accuracy of multi-choice questions alone. Our study extends the current scope by conducting a comprehensive analysis of GPT-4V's rationales of image comprehension, recall of medical knowledge, and step-by-step multimodal reasoning when solving New England Journal of Medicine (NEJM) Image Challenges - an imaging quiz designed to test the knowledge and diagnostic capabilities of medical professionals. Evaluation results confirmed that GPT-4V performs comparatively to human physicians regarding multi-choice accuracy (81.6% vs. 77.8%). GPT-4V also performs well in cases where physicians incorrectly answer, with over 78% accuracy. However, we discovered that GPT-4V frequently presents flawed rationales in cases where it makes the correct final choices (35.5%), most prominent in image comprehension (27.2%). Regardless of GPT-4V's high accuracy in multi-choice questions, our findings emphasize the necessity for further in-depth evaluations of its rationales before integrating such multimodal AI models into clinical workflows.

Zhengyun Zhao, Qiao Jin, Fangyuan Chen et al.

Objective: Retrieval-based Clinical Decision Support (ReCDS) can aid clinical workflow by providing relevant literature and similar patients for a given patient. However, the development of ReCDS systems has been severely obstructed by the lack of diverse patient collections and publicly available large-scale patient-level annotation datasets. In this paper, we aim to define and benchmark two ReCDS tasks: Patient-to-Article Retrieval (ReCDS-PAR) and Patient-to-Patient Retrieval (ReCDS-PPR) using a novel dataset called PMC-Patients. Methods: We extract patient summaries from PubMed Central articles using simple heuristics and utilize the PubMed citation graph to define patient-article relevance and patient-patient similarity. We also implement and evaluate several ReCDS systems on the PMC-Patients benchmarks, including sparse retrievers, dense retrievers, and nearest neighbor retrievers. We conduct several case studies to show the clinical utility of PMC-Patients. Results: PMC-Patients contains 167k patient summaries with 3.1M patient-article relevance annotations and 293k patient-patient similarity annotations, which is the largest-scale resource for ReCDS and also one of the largest patient collections. Human evaluation and analysis show that PMC-Patients is a diverse dataset with high-quality annotations. The evaluation of various ReCDS systems shows that the PMC-Patients benchmark is challenging and calls for further research. Conclusion: We present PMC-Patients, a large-scale, diverse, and publicly available patient summary dataset with the largest-scale patient-level relation annotations. Based on PMC-Patients, we formally define two benchmark tasks for ReCDS systems and evaluate various existing retrieval methods. PMC-Patients can largely facilitate methodology research on ReCDS systems and shows real-world clinical utility.