Cheng Ting Hsu

Hsin-Ling Hsu, Zizheng Wang, Donghua Zhang et al.

Most existing LLM diagnoses are evaluated on static, single-turn settings where complete patient information is provided upfront, an oversimplification of real clinical practice. We study active diagnosis: the real-life clinical process of starting from initial observation, ordering tests, interpreting results, and updating a differential diagnosis across multiple turns. Through systematic analysis, we identify three recurring failure modes in current LLMs: ungrounded test ordering, unreliable diagnostic update, and degraded multi-turn coherence. Together, these failures reveal a core deficit: existing medical training data teaches models to reason from complete information but not to act under evolving, partial evidence. To address this gap, we introduce MedAction, a tree-structured distillation pipeline that synthesizes diverse and high-quality multi-turn diagnostic trajectories via LLM-environment interaction. We propose two knowledge-graph-grounded metrics to filter trajectory quality: Disease Trajectory Consistency (DTC), which tracks whether the model's hypothesis converges toward the correct diagnosis, and Reasoning-Action Consistency (RAC), which verifies that belief updates are driven by gathered evidence. Using this pipeline, we construct MedAction-32K, a dataset of 32,681 trajectories from 2,896 PMC cases. Fine-tuning an 8B model on MedAction-32K achieves state-of-the-art performance among open-source models on both MedR-Bench and our curated MedAction-300-Hard benchmark, pushing the edge for open-source medical LLMs.

Chia-Hsuan Hsu, Jui-Ming Yao

Large language models show strong reasoning ability, but their internal reasoning process can remain unstable in complex multi-step settings, where early hidden-state errors may propagate to incorrect predictions. We propose ReLAR, a reinforcement-guided latent refinement framework that iteratively updates hidden representations before decoding. ReLAR maintains a compact latent reasoning state and uses learned depth and action controllers to adaptively determine both the number and direction of refinement steps. The controllers are trained with a policy gradient objective based on step-wise likelihood improvement, enabling efficient input-dependent reasoning without explicit chain-of-thought generation. Experiments on medical, mathematical, multi-hop reasoning, and open-ended generation benchmarks show that ReLAR improves accuracy, generation quality, and reasoning stability with substantially lower inference overhead than explicit reasoning baselines.

Pin-Yen Chiu, Dai-Jie Wu, Po-Hsun Chu et al.

Kinship face synthesis is a challenging problem due to the scarcity and low quality of the available kinship data. Existing methods often struggle to generate descendants with both high diversity and fidelity while precisely controlling facial attributes such as age and gender. To address these issues, we propose the Style Latent Diffusion Transformer (StyleDiT), a novel framework that integrates the strengths of StyleGAN with the diffusion model to generate high-quality and diverse kinship faces. In this framework, the rich facial priors of StyleGAN enable fine-grained attribute control, while our conditional diffusion model is used to sample a StyleGAN latent aligned with the kinship relationship of conditioning images by utilizing the advantage of modeling complex kinship relationship distribution. StyleGAN then handles latent decoding for final face generation. Additionally, we introduce the Relational Trait Guidance (RTG) mechanism, enabling independent control of influencing conditions, such as each parent's facial image. RTG also enables a fine-grained adjustment between the diversity and fidelity in synthesized faces. Furthermore, we extend the application to an unexplored domain: predicting a partner's facial images using a child's image and one parent's image within the same framework. Extensive experiments demonstrate that our StyleDiT outperforms existing methods by striking an excellent balance between generating diverse and high-fidelity kinship faces.

Chia-Hsuan Hsu, Jun-En Ding, Hsin-Ling Hsu et al.

Medical question answering requires advanced reasoning that integrates domain knowledge with logical inference. However, existing large language models (LLMs) often generate reasoning chains that lack factual accuracy and clinical reliability. We propose Ranked Preference Reinforcement Optimization (RPRO), a novel framework that combines reinforcement learning with preference-driven reasoning refinement to enhance clinical chain-of-thought (CoT) performance. RPRO distinguishes itself from prior approaches by employing task-adaptive reasoning templates and a probabilistic evaluation mechanism that aligns model outputs with established clinical workflows, while automatically identifying and correcting low-quality reasoning chains. Unlike traditional pairwise preference methods, RPRO introduces a groupwise ranking optimization based on the Bradley--Terry model and incorporates KL-divergence regularization for stable training. Experiments on PubMedQA, MedQA-USMLE, and a real-world clinical dataset from Far Eastern Memorial Hospital (FEMH) demonstrate consistent improvements over strong baselines. Remarkably, our 2B-parameter model outperforms much larger 7B--20B models, including medical-specialized variants. These findings demonstrate that combining preference optimization with quality-driven refinement provides a scalable and clinically grounded approach to building more reliable medical LLMs.