Pranav Mani

Manley Roberts, Pranav Mani, Saurabh Garg et al.

What sorts of structure might enable a learner to discover classes from unlabeled data? Traditional approaches rely on feature-space similarity and heroic assumptions on the data. In this paper, we introduce unsupervised learning under Latent Label Shift (LLS), where we have access to unlabeled data from multiple domains such that the label marginals $p_d(y)$ can shift across domains but the class conditionals $p(\mathbf{x}|y)$ do not. This work instantiates a new principle for identifying classes: elements that shift together group together. For finite input spaces, we establish an isomorphism between LLS and topic modeling: inputs correspond to words, domains to documents, and labels to topics. Addressing continuous data, we prove that when each label's support contains a separable region, analogous to an anchor word, oracle access to $p(d|\mathbf{x})$ suffices to identify $p_d(y)$ and $p_d(y|\mathbf{x})$ up to permutation. Thus motivated, we introduce a practical algorithm that leverages domain-discriminative models as follows: (i) push examples through domain discriminator $p(d|\mathbf{x})$; (ii) discretize the data by clustering examples in $p(d|\mathbf{x})$ space; (iii) perform non-negative matrix factorization on the discrete data; (iv) combine the recovered $p(y|d)$ with the discriminator outputs $p(d|\mathbf{x})$ to compute $p_d(y|x) \; \forall d$. With semi-synthetic experiments, we show that our algorithm can leverage domain information to improve upon competitive unsupervised classification methods. We reveal a failure mode of standard unsupervised classification methods when feature-space similarity does not indicate true groupings, and show empirically that our method better handles this case. Our results establish a deep connection between distribution shift and topic modeling, opening promising lines for future work.

Daniel P. Jeong, Pranav Mani, Saurabh Garg et al.

Several recent works seek to adapt general-purpose large language models (LLMs) and vision-language models (VLMs) for medical applications through continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining improves performance on various downstream medical tasks, such as answering medical exam questions. In this paper, we compare ten "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting and supervised fine-tuning regimes for medical question answering (QA). For instance, on clinical-note-based QA tasks in the 3-shot setting, medical LLMs outperform their base models in only 26.7% of cases, reach a (statistical) tie in 16.7% of cases, and perform significantly worse in the remaining 56.7% of cases. Our conclusions are based on (i) comparing each medical model directly against its base model; (ii) optimizing the prompts for each model separately in zero-/few-shot prompting; and (iii) accounting for statistical uncertainty in comparisons. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Karen Zhou, John Giorgi, Pranav Mani et al.

AI-generated clinical notes are increasingly used in healthcare, but evaluating their quality remains a challenge due to high subjectivity and limited scalability of expert review. Existing automated metrics often fail to align with real-world physician preferences. To address this, we propose a pipeline that systematically distills real user feedback into structured checklists for note evaluation. These checklists are designed to be interpretable, grounded in human feedback, and enforceable by LLM-based evaluators. Using deidentified data from over 21,000 clinical encounters (prepared in accordance with the HIPAA safe harbor standard) from a deployed AI medical scribe system, we show that our feedback-derived checklist outperforms a baseline approach in our offline evaluations in coverage, diversity, and predictive power for human ratings. Extensive experiments confirm the checklist's robustness to quality-degrading perturbations, significant alignment with clinician preferences, and practical value as an evaluation methodology. In offline research settings, our checklist offers a practical tool for flagging notes that may fall short of our defined quality standards.